..ft/?** 

.SL M3 



J« 



LIBRARY OF CONGRESS 



021 060 435 2 * 



Hollinger Corp. 
P H8.5 



HV 3006 
.S6 N3 
Copy 1 



A REPORT 



**l J*» 



of the \^y 



\u 



SOUTH CAROLINA MENTAL 
HYGIENE SURVEY 

with 

RECOMMENDATIONS 



Survey Authorized by the Honorable Robert A. Cooper, 
Governor of South Carolina 



Conducted by The National Committee for Mental 

Hygiene under the Auspices of the South 

Carolina Mental Hygiene Committee 



V. V. ANDERSON, M. D. 

Associate Medical Director 

The National Committee For Mental Hygiene 

New York City 



The State Co., Columbia, S. C. 



A REPORT 

of the 

SOUTH CAROLINA MENTAL 
HYGIENE SURVEY 

with 

RECOMMENDATIONS 



Survey Authorized by the Honorable Robert A. Cooper, 
Governor of South Carolina 



Conducted by The National Committee for Mental 

Hygiene under the Auspices of the South 

Carolina Mental Hygiene Committee 



V. V. ANDERSON, M. D. 

Associate Medical Director 

The National Committee For Mental Hygiene 

New York City 



H\/3oob 

SOUTH CAROLINA MENTAL HYGIENE COMMITTEE 



Dr. Patterson Wardlaw, Chairman; 

Dr. Josiah Morse, 

Mrs. E. S. Watkins, 

Dr. B. O. Whitten, 

Dr. C. F. Williams, 

Sylvia Allen, 

Louise E. Bishop, 

Mrs. Ruth A. Dodd, 

Dr. Grace Helen Kent, 

Dr. D. B. Johnson, 

Bishop Kirkman G. Finlay 



LIBRARY OF CONGKtSS 

RECEIVED 

MAY 181922 



COMMITTEE'S REPORT TO THE GOVERNOR. 



<2 

.* Columbia, January 20, 1922. 

^j Hon. Robert A. Cooper, Governor y Capitol, Columbia, S. C. 

Dear Sir : The Committee on Mental Hygiene of this state has 
been acting in an advisory capacity to the survey staff of the Na- 
tional Committee for Mental Hygiene which, for the past year 
has, at your request been conducting a mental hygiene survey of 
South Carolina. Our committee has cooperated in every way 
possible with the National Committee for Mental Hygiene during 
the time that this survey was in progress. The accompanying re- 
port of the work done, with conclusions and recommendations 
has been received by us and has our most hearty approval. This 
splendid piece of generosity on the part of the National Com- 
mittee will, we believe, prove to be of high value to this state. 
We hereby ask leave to submit this report to you. 

The committee begs to suggest that you have this report 
printed for presentation to the members of the General Assem- 
bly, with an additional limited number of copies for the dis- 
tribution to boards, commissions, superintendents and others 
especially interested in this particular subject. 
Very respectfully submitted, 

Patterson Wardlaw, Chairman: 
Mrs. E. S. Watkins, 
Mrs. Ruth A. Dodd, 
Louise E. Bishop, 

B. O. Whitten, M. D. 
Josiah Morse, 

D. B. Johnson, 
Grace Helen Kent, 

C. F. Williams, M. D. 
K. G. Finlay. 



4 
LETTER OF TRANSMITTAL. 



Columbia, February 1, 1922. 

To the Members of the General Assembly of South Carolina: 

During the year 1921, at the request of the State Board of 
Public Welfare, the Child Welfare Commission, myself and 
many citizens of the State, the National Committee on Mental 
Hygiene carried on a survey in South Carolina. Their work was 
conducted in cooperation with the State Board of Public Wel- 
fare, The State Board of Health, the State Hospital and the 
State Superintendent of Education, and all of these cooperating 
agencies gave both their time and their labor to the furthering of 
the great task. This survey covered many jails, the prison, 
schools, orphanages and other groups of people and it was most 
carefully made by persons of high training and great skill. Its 
results therefore are accurate and are to be received with con- 
fidence. 

I am transmitting to you the report of this survey for your 
information and for whatever action your wisdom dictates that 
you shall take on it. The extent of feeblemindedness in South 
Carolina is alarming. Not that our State is especially cursed 
with this evil, for other states are in a like plight, but the subject 
had not been brought so smitingly to our attention before. I 
am sure that you will do what you may to remedy this evil. The 
report emphasizes the necessity of treatment and of prevention. 
We have an excellent small State Training School for the Feeble- 
minded. Its capacity is one hundred and it has now exceeded 
that number of inmates. I ask that you consider carefully the 
advisability of enlarging this institution as soon as it is possible 
for you to do so. There is also a necessity of taking some steps 
to give the proper care to those feebleminded persons that can- 
not be received at the Training School. This may be done under 
proper supervision at their homes, and at a small expense to the 
State. However, the great work is that of prevention, prevention 
of the increase of feeblemindedness and prevention of the ills 
that come from feeblemindedness. Should measures be taken 
to prevent the propagation of children by these weak minded 
persons the increase of mental deficiency would soon be staid, 
and if those that are feebleminded were properly cared for 



much crime and dependency in South Carolina would be wiped 
out. 

I have only called attention to several outstanding features of 
this report, and I urge that you read it carefully and take ac- 
tion thereon. 

Respectfully, 

Robert A. Cooper, 
Governor. 



SURVEY STAFF. 

Dr. V. V. Anderson, Associate Medical Director, The National 

Committee for Mental Hygiene, Director of Survey. 
Dr. Frank J. O'Brien, Assistant Director of Survey. 
Dr. Arabelle J. Feldkamp, Psychiatrist. 
Mr. C. L. Hultgren, Psychologist. 
Miss Willie Stevens, Psychologist. 
Miss Mina Sessions, Psychiatric Social Worker. 
Miss Dorothy Horne, Secretarial Assistant. 



ACKNOWLEDGMENT. 

It would be difficult to estimate our indebtedness to various 
individuals, public officials, and state and private agencies. We 
wish, however, to express our great appreciation to Mr. G. Croft 
Williams and to every member of the Advisory Committee, to 
various officials connected with the State Board of Public Wel- 
fare, to the State Board of Health, to the State Superintendent 
of Schools, and to all who have so kindly and generously given of 
their time and advice to this survey. 

We also wish to extend our appreciation to the Department of 
Statistics of the National Committee for Mental Hygiene for 
their very valuable aid in compiling the data collected in the field. 



TABLE OF CONTENTS. 

Page 

Introduction 8 

Scope of Survey 9 

Methods Employed 9 

Presentation of Data 10 

Public Schools 10 

Charleston 10 

Columbia 10 

Greenville County 10 

Anderson County 10 

Orangeburg County 10 

Pickens County 10 

Delinquency 24 

Adult Delinquents 24 

State Penitentiary, Columbia 24 

De Saussure Farm (Penitentiary), Boykin 24 

Reid Farm (Penitentiary), Boykin 24 

Anderson County Jail, Anderson 32 

Charleston County Jail, Charleston 32 

Florence County Jail, Florence 31 

Kershaw County Jail, Camden 30 

Lexington County Jail, Lexington 31 

Pickens County Jail, Pickens 31 

Richland County Jail, Columbia 33 

Juvenile Delinquents 33 

Juvenile Court, Columbia 33 

Fairwold Industrial School for Girls, Columbia 36 

Industrial School for Girls, Columbia 37 

State Reformatory for Negro Boys, Columbia 40 

Industrial School for Boys, Florence 44 

Dependency 50 

Juvenile Dependents 50 

Orphan House, Charleston 50 

Jenkins Orphanage, Charleston 51 

De la Howe State School 53 

Rescue Orphanage, Columbia 55 

Epworth Orphanage, Columbia 57 

City Orphan Asylum, Charleston 60 

Adult Dependents 61 

Anderson County Almshouse 61 

Lexington County Almshouse 61 

Pickens County Almshouse 61 

Charleston Home 61 

Ashley Asylum for Aged 61 

Summary 62 

Care of the Insane 63 

Care of the Feebleminded 68 

Conclusions 72 

Recommendations 73 



INTRODUCTION. 

The separate care of the feebleminded in South Carolina dates 
from the establishment of the State Training School by the Gen- 
eral Assembly of 1918. The original appropriation was for $60,- 
000. At first the institution was placed under the administration 
of the Board of Regents of the South Carolina State Hospital, 
but in 1920 it was transferred from the State Board of Regents 
to the State Board of Public Welfare, and was opened for the 
reception of patients on September 14th of the same year. It is 
located two miles east of Clinton on a tract of about 1,000 acres; 
a detailed account of its layout, organization, administration, 
and operation is presented later on in this report. At the present 
date there are only 103 patients and the institution is overcrowded. 
There is, moreover, a very large waiting list. 

The special class instruction of mental defectives in the public 
schools of South Carolina has made little progress outside of a 
few communities. Charleston, Columbia and Rock Hill have 
special classes. The organization and equipment of these special 
classes, as well as the character of work done, will be taken up 
in that phase of this report devoted to the study of public school 
children. 

Other than those mentioned above, there are no facilities for 
the care of the feebleminded in this state. There is no state- 
wide supervision, after-care, or parole of mental defectives. 
Though there are several thousand mental defectives in the state, 
only 103 are receiving proper institutional care and only 104 are 
being given special-class instruction in the public schools. 

Because of the importance of this problem, because of its size 
and menace, and because of the desire to profit by the experience 
of other states in dealing with mental defectives, various public 
agencies, state officials, and private citizens in South Carolina 
became interested in a state-wide study of this condition. Out 
of this interest grew an appeal to Governor Cooper for a mental- 
deficiency survey. With the purpose of centering interest on this 
problem, a group composed of the following citizens was organ- 
ized into the South Carolina Mental Hygiene Committee: Dr. 
Patterson Wardlaw, Chairman; Dr. Josiah Morse, Mrs. E. S. 
Watkins, Dr. B. O. Whitten, Dr. C. F. Williams, Miss Sylvia 
Allen, Miss Louise E. Bishop, Mrs. Ruth A. Dodd, Dr. Grace 
Helen Kent, Dr. D. B. Johnson, and Bishop Kirkman G. Finlay. 



9 



At the request of this Committee, Governor Kobert A. Cooper, 
during the fall of 1920 extended an invitation to The National 
Committee for Mental Hygiene to conduct a mental-deficiency 
survey of South Carolina. Money being available for this pur- 
pose through a special appropriation by the Kockefeller Foun- 
dation, The National Committee for Mental Hygiene was able to 
accept the Governor's invitation. The survey has now been under 
way since the month of January, 1921, and includes a study of 
the care of both the feebleminded and the insane. 

SCOPE OF SURVEY. 

The survey staff set itself to determine first what sort of prob- 
lems feeblemindedness and insanity are to the state, and what 
relationship they bear to other social problems. Aside, from a 
study of the facilities of the various state, county, and city insti- 
tutions, private agencies, and public schools, for dealing with 
mental defectives and mentally sick persons, the survey included 
a very careful examination of all the inmates of the following 
institutions: the State Penitentiary, the De Saussure Farm at 
Boykin, the Reid State Farm at Boykin, the Fairwold Industrial 
School for Colored Girls, the State Industrial School for Girls at 
Columbia, the State Reformatory for Negro Boys at Columbia, 
the Industrial School for Boys at Florence, the Orphan House in 
Charleston, the Jenkins Orphanage in Charleston, the De la Howe 
State School, the Rescue Orphanage in Columbia, the Epworth 
Orphanage in Columbia, the City Orphan Asylum in Charleston ; 
examinations were also made of the inmates of county jails and 
county almshouses in Anderson, Charleston, Florence, Kershaw, 
Lexington, Pickens, and Richland Counties; of a "run of the 
mine*' of the Juvenile Court in Columbia, and of public-school 
children in various parts of the state representing city, town, 
and rural communities. Heredity studies of defective families 
were another phase of the survey, and finally, a study was made 
of the State Hospital and the State Institution for the 
Feebleminded. 



METHODS EMPLOYED. 

The study included, in the case of each individual examined, a 
social and medical history, a history of delinquent behavior, an 
employment record, and such facts as could be gathered bearing 



10 

upon personality make-up, mental traits and characteristics, and 
temperamental difficulties, together with a careful mental exami- 
nation (both psychiatric and psychological) of each and every 
person. 

In the case of public-school children, a physical inspection and 
a quick physical examination were made. On all public-school 
children a history bearing upon physical and mental develop- 
ment, physical defects and illnesses, progress and standing in 
school, personality traits and behavior, was obtained. In ad- 
dition to this, all the children were given mental examinations 
by the group-test method. From the data thus secured, we 
selected the children who required individual examination, the 
criteria being physical condition, evidence of behavior difficulties, 
low intelligence rating, etc. In addition, we gave individual 
examinations to all problem cases referred by the teachers, who 
had been requested in advance to make out lists of all pupils over 
age for grades, all subnormal and dull pupils, all delinquent and 
disciplinary cases, all who were peculiar or, to the teacher's mind, 
deviated in any way from the normal. We believe that in this 
way we probably did not overlook any children who needed a 
mental examination. As regards adolescents and adults, all re- 
ceived a careful, intensive, and individual examination. 

PRESENTATION OF DATA. 

Public Schools. 

The problem that presented itself in connection with the survey 
of public school children was to select counties representing 
typical sections of the state — the mountain group, the agricultural 
section, the cotton mills, the saw mills, the sand-hill group, the 
city schools, and, finally, certain typical colored schools. The 
decision as to what counties to select was made in cooperation with 
the State Superintendent of Schools. In each county the decision 
as to what schools were representative was left to the county 
superintendent. 

This report contains only data gathered from a study of chil- 
dren in Pickens County, Anderson County, Greenville County, 
and the cities of Charleston and Columbia. 

The survey includes a study of 5,571 children in the elementary 
grades of the public schools, with an additional 720 high-school 



11 



and college colored students. There were 3,214 white children 
and 2,357 colored children. Practically the entire group were 
native born. Only 20 of the white children were foreign born, 
and only 6.4 per cent of the fathers and 5.6 per cent of the 
mothers of the white children were foreign born. All the negro 
children were American-born, all their fathers were American- 
born negroes, and all their mothers American-born, with the ex- 
ception of one who was born in the West Indies. 

The number of children in each grade studied is shown in the 
following table : 

TABLE I.— COLOR OF PUBLIC SCHOOL CHILDREN CLASSIFIED WITH REFERENCE TO 

GRADE ATTAINED. 



Grade Attained 


White 


Colored 


First Grade 


783 
528 
534 
478 
444 
420 
16 
11 

3,214 


• 999 




454 


Third Grade 


377 


Fourth Grade 


271 


Fifth Grade 


129 


Sixth Grade 


119 












8 


Total 


2,357 







Studying, as we did, every child in these particular grades in 
certain selected schools throughout the state, we believe not only 
that we have a fair sample of the public-school children in these 
grades in South Carolina, but that within this group we have 
included all the feebleminded children. Except on rare oc- 
casions feebleminded children do not progress further than the 
fourth or fifth grade, and never beyond the seventh grade. 

The median age and range of ages of both white and colored 
children in each grade is seen in the following table: 



TABLE II. 



-CHRONOLOGICAL AGES OF PUBLIC SCHOOL CHILDREN CLASSIFIED WITH 
REFERENCE TO GRADE ATTAINED 



White Children 



Colored Children 













Grade Attained 


Median ] 
Chronological | 


Range of Ages 


! 

Median 

Chronological 

Age 


Range of Ages 


First Grade 


7 

8 

9 1 
10 1 
11 
12 
13 


5-16 
6-15 
7-18 
8-18 
8-17 
8-19 
11-16 


■ 
8 

10 
11 
12 
13 
14 


5-15 
6-15 


Third Grade 


7-17 


Fourth Grade 


7-18 


Fifth Grade 


10-18 


Sixth Grade 


9-17 


Seventh Grade 





12 



It can be seen from the above table that in each grade the col- 
ored children are almost uniformly two years older than 
the white children. The very wide range of ages in each grade 
is significant. The presence of children eighteen years old in 
the same grade with children of seven years indicates that these 
schools are failing to meet special-class problems. 

A more serious indictment of the public schools is found in 
Table III which shows the mental ages according to grade. 

TABLE III.— TEST AGES OF PUBLIC SCHOOL CHILDREN CLASSIFIED WITH REFERENCE 

TO GRADE ATTAINED 





White Children 

1 


Colored Children 


Grade Attained 


Median 
Test Age 


Range of 
Ages 


Median | Range of 
Test Age 1 Ages 




5 
7 
7 
9 
9 
11 


4-10 
4-11 
5-12 
8-14 
7-13 
7-15 


6 
6 
7 
9 
9 
10 


4-10 




4-10 


Third Grade 


5-15 


Fourth Grade 


6-11 


Fifth Grade 


7-14 


Sixth Grade 


8-13 









It can be seen from this table that, while there is in general a 
relationship between the grade attained and the mentality of the 
pupil, still, children testing fifteen years mentally are found in 
the third grade along with children testing only five years. 
It requires no elaboration of these findings to point out the urgent 
need for special and ungraded class instruction for the large 
number of special problem pupils that are to be found in any com- 
munity. These children not only fail to profit by what the 
schools are endeavoring to give them, but are a hindrance and a 
grave handicap to the other children in the class. This holds 
good not only for the retarded children, but for the exceptionally 
bright children, who are being slowed down to the level of 
average and inferior minds. The unnecessary cost in dollars and 
cents of repeating grades might be considered as a practical issue. 

There are many and varied causes for mental retardation in 
public school children. A child may be backward because of 
language difficulties, failure or irregularity of attendance at 
school, ill health, physical defects, insufficient nourishment, bad 
home conditions, overwork at home after school hours, lack of 
proper sleep, marked handicaps of personality, adaptive difficul- 
ties, and finally, mental defect. Proper study and treatment of 



13 



the causes underlying mental retardation frequently serve to re- 
turn many of these children to the regular grades. 

The frequency of mental defect, subnormal intelligence, psy- 
chopathic states, physical defects, and adaptive difficulties among 
children in this group is brought out in the following tables : 

TABLE IV.— COLOR OF 5,571 PUBLIC SCHOOL CHILDREN CLASSIFIED WITH REFER- 
ENCE TO MENTAL DIAGNOSIS* 



Diagnosis 


| White 


Colored 


Number 


Per Cent 


Number Per Cent 




1711 
737 
557 
60 
91 
21 
4 


53.2 
22.9 
17.3 
1.9 
2.8 
0.6 
n 1 


752 

779 

630 

87 

100 

1 

2 

4 

2 

2357 


31 9 




33.1 




26.7 


Borderline mental defect . . 


3.7 

4.2 


Psychopathic personality . . 


' 0.0 

1 


Endocrine disorder 


21 0.7 
12 n * 


0.2 

01 


Total 


is 


100.0 


100.0 



*No child was called "mental defective" who had mental retardation of less than three 
years; usually four years were allowed, and a far more generous allowance was made for 
all colored children. 

From the above table it is seen that 2.8% of the white public- 
school children examined were feebleminded, and 4.2% of the 
colored public school children. If these figures hold good for the 
entire public school population of South Carolina — and we be- 
lieve that we selected a fair sample — then there are over 13,000 
feebleminded children in the public schools of the State. 

In addition there is a group diagnosed as "borderline mental 
defectives." In the case of these individuals, it was impossible, 
owing to the lack of sufficient information on such matters as 
heredity history, developmental history, medical and other data, 
to make a positive diagnosis of mental defect. The intellectual 
rating, however, was so low as to cause us to feel that the great 
majority would ultimately have to be classed as mental defectives. 

Fully 23.4% of the white children and 34.9% of the colored chil- 
dren in the public schools studied were either subnormal in intel- 
ligence, feebleminded, or suffering from psychopathic personality, 
a psychoneurosis, epilepsy, or an endocrine disorder. The import 
of these conditions, their meaning to school officials as well as to 
other public agencies, and the bearing they have upon social prob- 
lems in general will be dealt with later on in this report. 



14 



Comparative figures of the mental diagnoses of public school 
children classified according to environment may be of interest. 
The following table shows the frequency of these conditions in 
urban and rural communities: 



TABLE V-(a).-ENVIRONMENT OF WHITE PUBLIC SCHOOL CHILDREN CLASSIFIED 
ACCORDING TO MENTAL DIAGNOSIS 



Diagnosis 



Normal 

Dull normal 

Subnormal 

Borderline mental defect 

Mental defect 

Psychopathic personality 

Endocrine disorder 

Epilepsy 

Unascertained 

Total 



Urban 


Rural 


| Number J Per Cent 


Number 


Per Cent 


1 
1,074 1 63.6 


637 


41.8 


340 | 20.1 


397 


26.0 


191 j 11.3 


366 


24.0 


26 1.5 


34 


2.2 


26 1.5 


65 


4.3 


1 12 | 0.7 


I 9 | 0.6 


10 | 0.6 


I 11 | 0.7 


I 2 | 0.1 


| 2 0.1 


8 | 0.5 

] i 


, 4 


0.3 


1,689 


100.0 


1,525 


100.0 



TABLE V-(b).— ENVIRONMENT OF COLORED PUBLIC SCHOOL CHILDREN CLASSIFIED 
ACCORDING TO MENTAL DIAGNOSIS 



Diagnosis 



Urban 



Rural 



| Number | Per Cent I Number I Per Cent 



Normal 

Dull normal 

Subnormal 

Borderline mental defect. 

Mental defect 

Psychopathic personality 

Endocrine disorder 

Epilepsy 

Unascertained 



527 

590, 

437 

50 

66 

"*4 

1 



1 

31.5 | 


35.2 


26.1 


3.0 


3.9 


0.2 


0.1 



225 

189 

193 

37 

34 

1 

"i 

2 



Total | 1,675 



| 100.0 



33.0 

27.7 

28.3 

5.4 

5.0 

0.1 



0.1 
0.3 



100.0 



There is nothing particularly significant in regard to the com- 
parative frequency of psychopathic conditions, epilepsy, and 
endocrine disorders in the foregoing table. But it is notice- 
able that subnormal mentality and feeblemindedness do vary. 
There is a higher frequency of these conditions in rural sections 
than in cities — in certain instances twice as high. This is in 
keeping with army figures, which showed that two-thirds of the 
cases of feeblemindedness came from rural districts. 

Discussion of Mental Conditions Found Among School Children. 
There are five distinct types of problem children to which we 



15 

wish to call special attention in this phase of our report: the 
retarded child, the nervous and psychopathic child, the mental 
defective, the epileptic child, and the child suffering from speech 
defect. 

The Retarded Child. 

The dull and subnormal child, whose mental backwardness is 
not of such a degree as to require special class training with the 
feebleminded, but who, because of his retarded mentality, is in 
need of more specialized training than he can secure in the 
regular grade, is the type referred to here. It is this type of pupil 
for whom ungraded classes are created. 

For the great majority of these children the chances for normal 
development and mental health are probably good, provided early 
and proper diagnosis is made and suitable treatment and training 
are instituted. 

Every backward child should receive a complete physical and 
mental examination and home investigation. Proper study and 
treatment of the causes underlying the mental backwardness of 
these children frequently serve to return them to the regular 
grades. 

In life the mental equipment of the backward child is not quite 
sufficient to enable him to measure up to the complex demands 
made upon him, and a large proportion of failures and break- 
downs are drawn from this group. And yet we find among 
retarded children the same ambition and the same striving for 
success as in the more normally endowed. 

The particular difficulties and varied problems presented by 
these individuals are not to be solved merely by determining their 
intellectual ratings and I. Q's. We must know also the causes of 
the mental retardation. Each case is an individual problem, 
presenting varied medical, psychological, sociological, and ped- 
agogical angles. 

The Nervous and Psychopathic Child. 

This type of child is neither insane nor feebleminded. He may 
have good intelligence and, on a purely intellectual basis would 
often be classed as normal ; yet children of this type furnish the 
most difficult problems to be met with in the public schools, and 
in later life are one of the largest sources of delinquency and 
insanity. 



16 

These children show outstanding handicaps of personality that 
mark them as different from other children. Their adaptive 
difficulties are the expression of mental attitudes, mental trends 
and twists that constitute a very marked departure from normal 
mental health. 

Various types of psychopathic children are to be found in the 
public schools: the very thin, under-nourished, overactive, rest- 
less, neurotic, emotional, violent tempered child ; the apathetic, 
weak-willed, physically inert, sluggish, oversuggestible, inade- 
quate child; the egocentric, selfish, egoistic, unappreciative, 
cruel, ungrateful, individualistic child ; the shut-in, self-centered, 
unapproachable child ; the timid, hypersensitive child, with feel- 
ings of inferiority; and many other types with psychopathic 
traits that seriously handicap them in adapting themselves to 
their environment. 

We shall not endeavor to go into the many causes for these 
conditions. They are varied and are found within the individual 
himself (in disorders of the physical organism, which are trace- 
able to an inherited constitution), or are environmental in origin 
due to the factors in the home, in the school, in work and in play. 
We do wish to emphasize, however, the importance of early recog- 
nition of these psychopathic conditions among school children. 
Daily is it becoming more and more apparent that many adult 
breakdowns are directly traceable to child life. A psychopathic 
personality forms the very richest soil possible for insanity in 
adolescence and in adult life, and is a very large factor in juvenile 
delinquency. 

With our changing attitude towards insanity and crime, with 
our present realization that those conditions often show their 
beginnings in childhood and are, in a large measure, preventable, 
there can be no excuse for our neglect to deal intelligently and 
understanding^ with psychopathic children in the public schools. 
The examination of these children should be conducted in a clinic 
equipped to deal with both mental and physical issues. The great 
importance of a searching physical investigation is now made 
evident from the frequency with which disorders of the ductless 
glands, ovaries, testicles, thyroid, etc., are encountered. These 
children should receive a thoroughgoing study from a psychiatric 
as well as a psychological point of view. The question of psycho- 
tic and psycho-neurotic tendencies, the child's personality make- 



17 

up, his abilities and disabilities, should all receive careful consid- 
eration. A course of treatment for each psychopathic child 
should be mapped out only after such a comprehensive examina- 
tion has been made. 

Six-tenths of one per cent of the white public school children 
in this survey were classified as psychopathic personalities. This 
would make, for the entire white school population, 1,052 psy- 
chopathic white children in the elementary grades of the public 
schools of South Carolina. This is a very low figure and the 
higher grades will show a far greater frequency of this condition. 

The Mentally Defective Child. 

Two and eight-tenths per cent of the white children and 4.2 per 
cent of the colored children were classed as mental defectives. 
Applying these percentages to the total school population of the 
State, there would be 13,267 feebleminded children in the public 
schools of South Carolina — 1,911 white children and 8,356 col- 
ored children. 

One and nine-tenths per cent of the white children and 3.7 
per cent of the colored children were classed as borderline mental 
defectives. The great majority of these, we believe, will unques- 
tionably prove to be mental defectives. 

The significance of these figures cannot be ignored. There is 
no more important problem for the school authorities of South 
Carolina than that of mental deficiency. The feebleminded child 
is not only a misfit in the school, a burden to the teacher, and a 
hindrance to the other pupils in the school, but later on in life 
the sad combination of his childish mind and adult years brings 
him into conflict with society's customs and laws. 

The fact that this is an hereditary condition and the fact that 
mental defectives, if untrained, for the most part become de- 
pendents and delinquents, while if properly trained along indus- 
trial and vocational lines they may be, in a large measure, made 
self-supporting, puts a serious responsibility on the shoulders of 
public-school officials. 

As will be brought out later on in tables showing the findings 
in state, county, and city, penal, correctional, and dependent in- 
stitutions, feeblemindedness is one of the largest factors under- 
lying pauperism and repeated criminality. Feebleminded in- 
dividuals are costing the state vast sums of money and are re- 
producing their kind in large numbers without hindrance and 



18 

sending them out into the community. If we are to do anything 
to prevent these conditions, the time to accomplish this is during 
the early years of the school career. The keynote to the solution 
of the problem of feeblemindedness is early and intensive indus- 
trial and vocational training of the feebleminded child during 
developmental years, the time when he can profit by what we do 
for him. This can be accomplished only by state- wide organiza- 
tion of special classes for all defective children in the public 
schools, and by the equipment of the State Institution for the 
Feebleminded with education facilities to meet the problems of 
those children who cannot be trained in the public schools, or 
who are delinquent and dependent defectives. 

The present institutional facilities for the care of feebleminded 
children in this state are woefully inadequate. A large number 
of the mentally defective children in the community will, of 
course, require a period of institutional care and intensive train- 
ing. In the meantime and for many years to come, the only train- 
ing the great majority will ever receive will be in the public 
schools of the state. This must be borne in mind: mental de- 
fectives are trainable, if trained along proper lines, to work with 
their hands, to do something useful at which they can earn a 
living. 

Nothing worth while can ever be accomplished by academic 
training of feebleminded children. The vast financial burden 
and social mischief for which these individuals are responsible 
are, in a large measure, preventable, providing we train defec- 
tive children along occupational lines in the public schools and in 
the State Institution, give them the kindly supervision they are 
in need of when they leave the public schools, and send early to 
th6 State Institution those defective children who threaten to 
become delinquent and dependent. 

The Epileptic Child. 

The frequency of this condition in childhood is not definitely 
known, owing to the difficulties of making a diagnosis. In a 
survey of this kind only the gross cases, with definite histories of 
seizures and clinical evidence of epilepsy, could be included. 
One-tenth of one per cent of the children were diagnosed as epil- 
eptics. 

Some of these children are feeblemided and yet, because of their 
epileptic attacks, cannot be handled in special classes with mental 



19 

defectives. Many of them, before repeated seizures have pro- 
duced mental dullness, are of normal intelligence and are capable 
of keeping up with the regular grade work. But it is necessary 
to exclude them from the grades for the sake of other children 
as well as for the welfare of the epileptics themselves. Nothing 
is more distressing for the other children than to witness the 
severe convulsions from which these children suffer. As a result, 
the epileptic child is, in a large measure, excluded from the public 
schools, and he grows up in life having to face a double handicap 
— not only the affliction of his diseasce, but the additional burden 
of illiteracy. Special provision for the teaching of these children 
should be made. Many of them may be saved for useful work in 
life, for some are exceptionally capable individuals. It is believed 
that, through the careful training of these children from child- 
hood, much of the personality defect, as well as the danger of 
intellectual deterioration, may be prevented. 

Speech Defects. 

There is another type to which we wish to call special attention : 
the child suffering from speech disorders. Three hundred and 
thirty-nine, or 6.1 per cent of the 5,571 children studied, were 
found to be suffering from some form of speech disorder. 

We are here dealing with children who, in the great majority 
of instances, have good intelligence and learning capacity, and 
who are capable, if given the right help at the right time, of 
becoming successful men and women; but if their handicap is 
not early recognized and properly treated, they may result in 
social failures because of their inability to meet people and situa- 
tions in life. The constant embarrassment and shame resulting 
from stammering or stuttering or some other speech difficulty 
brings about a consciousness of inferiority that destroys the very 
foundation of self-confidence and self-assurance. 

The problem these children present is principally that of an 
emotional imbalance with rather definite psychopathic trends. 

These conditions are functional in the great majority of in- 
stances, but if not properly treated, they may persist throughout 
life. Under proper treatment they are largely recoverable. 

Speech classes should be organized for such cases under the 
direction of specially trained speech teachers. These children 
would not need to be removed from the grades, but at some period 



20 



during each day they should be excused from their regular work 
for a conference and special treatment by the special teacher. 

Physical Conditions. 

No mental-deficiency survey of public-school children is com- 
plete without a physical examination to detect at least gross 
physical conditions. Mental health and physical health are so 
essentially interdependent that they cannot well be considered 
separately. Many cases of mental dullness are, undoubtedly, 
physical in origin and recoverable. The influence of fatigue, 
physical illness, and poor nutrition in causing psychopathic states 
is now well known. The physical make-up of the individual is 
probably the foundation of his personality. The integrity of the 
various large internal organs has much to do with mental health. 
Their balanced functioning is not only essential to the physical 
health of the child, but to the maintenance of normal mental 
health as well. 

The urgent need of clinical facilities, not only for the diagnosis, 
treatment, and prevention of conditions that affect the mental 
health of public-school children, but for the recognition of gross 
physical conditions which are, undoubtedly, important causative 
factors of mental ill health, and are the forerunners of grave 
physical diseases in adult life, is now being generally stressed. 

Table VI gives some of the gross conditions that were detected 
by the examiners in this survey. 

TABLE VI.-SOMATIC DISEASES AND DEFECTS OF PUBLIC SCHOOL CHILDREN. 



Diseases and Defects 



| White | Colored 

I I 



Defective teeth 

Enlarged tonsils 

Adenoids , 

Nasal obstruction 

Glandular enlargements 

Eye defects 

Ear defects 

Bronchitis 

Under weight 

Over weight 

Anemia 

Heart disease 

Skin disease 

Spinal curvature 

Bright's disease 

Others 

Total defects 

No defects reported . . 




21 

Approximately 63 per cent (2129) white children and TO per 
cent (1653) colored children were suffering from some form 
of physical defect. No defects were reported for 1,085 white and 
for 704 colored children. Thirty-one per cent of the white chil- 
dren, and 30 per cent of the colored children were suffering from 
defective teeth. The length of this report will not permit of 
our going into details regarding this condition. The public, 
however, is becoming well informed as to the serious consequences 
that may result from neglected teeth; infections of internal 
organs may insidiously take place and result in serious distur- 
bances of health. 

Two hundred and twenty-one white children and 112 colored 
children showed very marked defects in vision. It is more hu- 
mane and economical to have pupils' eyes tested and eye glasses 
provided than to leave children handicapped and backward due 
to conditions that are remedial. Defective eyes with imperfect 
vision cause headaches, blurring of sight, and often serious at- 
tacks of eye strain with nausea and dizziness, conditions that 
lead to retardation in school work. 

Thirty per cent of the white children and 32 per cent of the 
colored children suffered from poor nutrition. The effects of 
this condition on the general health of the child, both physical 
and mental, are now believed to be very important. Milk cam- 
paigns throughout the country attest the widespread interest in 
this problem. 

Conduct Disorders of Public School Children. 

One of the most serious conditions threatening childhood is 
the danger that foundation may be laid for criminal careers. 
Disorders of conduct that lead to delinquency show themselves 
very early in the school period. Such socially unacceptable be- 
havior as persistent lying or stealing, cruelty, fighting, bad sex 
practices, and truancy are not uncommonly met with in the public 
schools. If misunderstood and unintelligently handled, these 
conditions develop into more serious departures from normal 
behavior and the individual is haled into the juvenile court. 

The majority of all criminal careers have their beginnings in 
childhood. The realization of this fact is causing public authori- 
ties and those interested in the prevention of crime to advocate 
the importance of centering all constructive social work on those 



22 

forces that train children for a wholesome and socialized adult 
life. 

In this survey the examiners took account of those children 
who showed such outstanding disorders of conduct as were clearly 
at variance with average behavior. Such abnormal behavior as 
sex perversions, sex promiscuity, cruelty, pugnacity, and per- 
sistent lying or stealing were recorded. Seven and five-tenths 
per cent of the white children and 13.4 per cent of the colored 
children showed such conduct disorders. 

It is significant that approximately 86 per cent of the white 
children (more than 5 out of 6) and 75 per cent of the colored 
children (3 out of 4) who were recorded as exhibiting socially 
unacceptable conduct were handicapped by marked difficulties in 
personality make-up ? by defects in character, of which, in a large 
measure, the behavior disorders were but an expression. The 
emotional, neurotic, impulsive, highly temperamental child; the 
egocentric, selfish, inconsiderate, individualistic child; the in- 
adequate, weak-willed, suggestible, indolent child ; the paranoid, 
suspicious child who "never got a fair deal," were among the 
more common types met with. 

The solution of the problems of these individuals, however, 
will never be accomplished by grouping them into types and giv- 
ing them a classification. Each and every individual is a complex 
problem unto himself, to be unraveled and adjusted only after the 
most painstaking and scientific inquiry. 

It is here, after a well-rounded clinical study, that the visiting 
teacher can be of incalculable service, not only to the school au- 
thorities in helping adjust the child to the routine requirements 
of the school curriculum, but (and this is of greater importance) 
in setting in motion machinery looking to the normal adjustment 
of the child to life. 

General Discussion of Public School Findings. 

Approximately 23 per cent of the white children and 35 per 
cent of the colored children in this survey were found to be in 
need of far more specialized training and treatment than were 
being given them in the regular grades. 

The subnormal child, the feebelminded child, the nervous and 
psychopathic child, the epileptic child, and children exhibiting 
conduct disorders are not only difficult problems for the school 



23 

authorities today, but if not properly diagnosed and given suit- 
able treatment and training, and, in the case of those who need it, 
kindly and friendly oversight and supervision, they are destined 
later on for breakdowns and failures and will constitute a large 
majority of the unimprovable cases of dependency, delinquency, 
and insanity for which public authorities and private agencies 
must make provision. 

This is a large and important problem — a problem that the 
public-school authorities of South Carolina have as yet done very 
little to meet. Charleston has only two special classes and these 
are housed in the same building with classes for normal children. 
And yet Charleston has a school population of 8,893 children, 
among whom would be found 297 feebleminded children. Colum- 
bia has done more to meet the needs of defective children. - There 
are six special classes with six special class teachers, an average of 
only ten pupils to a class, and all the classes are housed in a 
separate building. It may be noted here that the present day 
attitude is placing more and more upon the public schools the 
responsibility of training mental defectives. Five states (New 
York, Xew Jersey. Pennsylvania, Massachusetts, and Missouri) 
have made it compulsory to provide special classes for mental 
defectives in the public schools. 

Certain outstanding needs present themselves from this study 
of public school children: 

(a) Clinical facilities for the diagnosis of all problem cases 
in the public schools. 

(b) The organization of special and ungraded classes to 
meet the needs of the various types of mentally handi- 
caped children. 

(c) Visiting teachers to carry out treatment, social adjust- 
ment, after care, and supervision of problem children. 

(d) Finally, state supervision and care of all neglected, de- 
pendent, and delinquent feebleminded children. 

Mental Clinic. 

In considering the clinical facilities needed for the public 
schools, the kinds of problems presented for study must be borne 
in mind. Probably the simplest and least important of all is 
the intellectual rating of the child. Complex disorders of con- 
duct offer a far more difficult problem for solution. 



24 

The clinic should study each child as an integrated organism. 
A complete physical, psychiatric, and psychological examination, 
as well as a social investigation, is the minimum to be desired 
in each case. A fairly complete personnel would be found in 
the following staff : 

Psychiatrist (Director) , 

Phychologist, 

Psychiatric Social Worker, 

Clerical Assistant. 

In certain states, notably Massachusetts, the clinical work 
for the public school is being done by the state hospitals and 
state institutions for the feebleminded at no additional expense 
to the state. 

This is a service these institutions may well offer, inasmuch 
as they are best qualified to deal with just the particular type 
of problems that are presented, having on their staffs physicians 
specially trained in mental medicine. 

In South Carolina, neither the Hospital for the Insane, nor 
the State Institution for the Feebleminded have as yet de- 
veloped mental clinics for public schools. This is a service that 
both institutions should be expected to render. 

DELINQUENCY. 

The data under this heading were obtained from a study of 
the inmates as well as the facilities of the State Penitentiary, 
Columbia ; the two state farms connected with the Penitentiary ; 
the Anderson County Jail; the Charleston County Jail; the 
Florence County Jail ; the Kershaw County Jail : the Lexington 
County Jail; the Pickens County Jail; the Richland County 
Jail; the Juvenile Court in Columbia; the Fairwold Indus- 
trial School for Colored Girls, Columbia; the Industrial School 
for Girls, Columbia; the State Reformatory for Negro Boys, 
Columbia; and the Industrial School for Boys at Florence. 

State Penitentiary. 

Three hundred and ten individuals were studied at this in- 
stitution. Fifty-five of these were at the Reid Farm and 52 at 
the De Saussure State Farm. Two hundred and sixty-four 
were males and 46 females, 194 were black and 116 white. With 
the exception of one individual, all were American born. Two 



25 

hundred and thirty-eight individuals, or 76.7 per cent, were born 
in South Carolina. One hundred and fifty, or 48.3 per cent, 
were single, 125, or 40.3 per cent, were married; 26, or 8.4 per 
cent were widowed; 3, or 0.9 per cent divorced; and 6, or 1.9 
per cent, were separated. The ages of these individuals ranged 
from 13 to 76 years inclusive. The median age was 28 years. 
Fifty-nine per cent were 30 years or under. 

One hundred and three individuals, or 33.2 per cent of the 
total number, had never gone to school and were illiterate. 
Thirty-five, or 11.3 per cent, never got further than the first 
grade in the public schools; 28, or 9 per cent, never got further 
than the second grade ; 29, or 9.4 per cent, never got further than 
the third grade; 25, or 8.1 per cent, never got further than the 
fourth grade; 63, or 20.3 per cent, got as far as the fifth, sixth, 
seventh, and eighth grades; 15 reached high school; and 10, or 
3.2 per cent, received some college education. In the case of 2 
individuals the amount of education was unascertained. 

The following table indicates the general nature of the offenses 
for which these individuals were sentenced: 

TABLE VII.— TYPES OF OFFENSE OF INMATES OF STATE PENITENTIARY. 

Type of Offense Number 

Offenses against property (stealing, breaking and entering, burglary, 

highway robbery, etc. ) 129 

Sex offenses 28 

Assault and battery 24 

Murder and manslaughter 108 

Arson 7 

Bigamy 3 

Violation of liquor laws 7 

Abduction 1 

Reckless driving 1 

Embezzlement 2 

Total 310 

It is interesting to note that approximately 40 per cent of 
the inmates of this institution were repeated offenders, individ- 
uals who had served previous sentences and had been in and 
out of court for various offenses before, individuals in whom 
the state had failed to accomplish that which it had set out to 
accomplish — their reformation. (Forty-two per cent of the in- 
mates of the Georgia State prison, 45 per cent of the inmates 
of the Wisconsin State prison, and 51 per cent of the inmates 
of the West Virginia State Penitentiary were found to be re- 
peated offenders.) 



Some facts bearing upon the mental condition of the inmates 
of this institution are presented in the following tables: 



TABLE VIII.-TEST AGE OF ADULT INMATES OF THE STATE PENITENTIARY. 



Test Age 


Total 


White 


Colored 


Seven vears and under 


31 
53 
65 
27 
30 
25 
16 
4 
2 
3 
2 
26 
26 


1 

4 

11 

12 

21 

14 

9 

1 

2 

3 

1 

26 

n 


30 
49 
54 
15 
9 
11 
7 
3 


Eight rears 




Ten years 


Eleven vears 


Twelve vears 


Thirteen vears 




Fifteen years 






Seventeen years 


1 


Adult 




Unascertained 


15 




Total 


310 


116 


194 





Twenty-four and one-tenth per cent of the white inmates of 
this institution and 76.3 per cent of the colored — that is, approxi- 
mately 57 per cent of the total number of inmates, or more than 
1 out of every 2, had the intelligence of the average child of 
ten years or under. 

It is now coming more and more to be realized that few 
factors play so important a part in crime as the mental condition 
of the offender, and that prevention of future criminal conduct 
must be based upon a better knowledge of the offender's mental 
make-up. This does not in any way lessen the importance of 
other factors and influences that are responsible for criminal 
conduct. 



TABLE IX. 



-MENTAL DIAGNOSIS OF THE INMATES OF THE STATE PENITENTIARY 
CLASSIFIED WITH REFERENCE TO SEX AND COLOR. 



Mental Diagnosis 


White 


Colored 


Males 


Females 


1 

'Number Per Cent 

1 


Number 


Per Cent 


Number 


Per Cent 


Number 


Per Cent 




16 ] 21.9 
9 12.3 

7 9.6 

8 11.0 
21 28.8 

8 | 11.0 
4 | 5:5 


43 
43 
50 
52 
21 
21 
4 
2 

1 


18.1 

18.1 

21.1 

21.9 

8.9 

8.9 

1.7 

0.8 

0.4 


57 
47 
43 
42 
38 
28 
7 
1 

1 


21.6 
17.8 
16.3 
15.9 
14.4 
10.6 
2.7 
0.4 

0.4 


2 
5 
14 
18 
4 
1 
1 
1 


4.3 




10.9 




30.4 




39.1 


Psychopathic personality 


8.7 
2.2 




2.2 


Endocrine disorder 

Drug addiction with- 
out psychosis 


2.2 



Total 



100.0 



237 | 100.0 | 264 | 100.0 | 46 | 100.0 



27 

Sixty-four and two-tenths per cent of the inmates of this insti- 
tution were classified as either subnormal in intelligence, mentally 
defective, psychopathic in make-up, or suffering from epilepsy, 
mental disease, drug addiction, or an endocrine disorder. Sixty 
or 19.4 per cent were diagnosed as feebleminded, five of whom 
were whites and eight negroes. It may be interesting to compare 
these figures with those of our studies in other institutions : 12% 
of the inmates of the Wisconsin Prison were found to be feeble- 
minded ; 21% of the inmates of Sing Sing Prison, New York; 28% 
of the inmates of the West Virginia Penitentiary ; 22.7 per cent 
of the inmates of the Maryland State Penitentiary ; and 17.5 per 
cent of the inmates of the Georgia State Prison. Eight of the 
white inmates and twenty-one of the negro inmates were suffering 
from mental disease. 

Another factor that stands out here as a matter of importance 
is the great frequency of character and personality difficulties 
among offenders. We find indolence, lack of ambition, egoism, 
selfishness, ingratitude, lack of appreciation, impulsiveness, insta- 
bility, violent temper, emotionality and many other personality 
difficulties that we believe must undoubtedly prove important 
factors in determining the conduct of the great majority of these 
persons. So frequently were these abnormal traits present that 
we found it quite possible to classify the prisoners according to 
certain definite types of personality make-up : the emotional type, 
the egocentric type, the paranoid type, and the inadequate type. 
To be sure, there was much overlapping in all cases. 

Persons classified as emotional were impulsive, neurotic, tem- 
peramental, unstable, restless, sensitive, violent tempered, etc. 
The egocentric type were very selfish, unappreciative, egoistic, 
individualistic, instinctive and often cruel. The inadequate type 
were lazy, inactive, unambitious, weak-willed, suggestible, etc. 
The paranoid type had ideas of a persecutory nature, never got 
a fair deal, were always being imposed upon, or were not 
properly appreciated for the abilities they possessed. 

The following table shows the frequency of these types : , 

TABLE X— PERSONALITY TYPES OF INMATES OF THE STATE PENITENTIARY. 

Personality Type Number 

No outstanding difficulty 90 

Emotional 29 

Egocentric 62 

Inadequate 68 

Paranoid 3 

Combination of types 52 

Unascertained 6 

Total 310 



28 

It is significant that approximately 72.1% of the repeated 
offenders at this institution showed marked handicaps in their 
personality make-up. 

The physical health of the inmates of this institution was 
rather poor. Fifty-nine per cent were suffering from conditions 
that needed medical attention. Approximately 18% were known 
to be suffering from syphilis. 

From the foregoing tables it is seen that more than half of 
the inmates can be classified as deviating from average mental 
health; also that more than half of the inmates were suffering 
from conditions that called for medical attention. There are 
hospital facilities, but the equipment is poor. There is a regular 
attending physician who comes every day and in emergencies. 
There are no facilities whatever for mental classification of the 
inmates, and little attention is given to the educational training 
of the prisoners. Well trained teachers would be a profitable 
investment for this institution. 

There was a lack of individualization in dealing with offenders 
which is due to the inadequate facilities at the prison for finding 
out and meeting the needs of each case. The guards, who are 
in close contact with the men, have an unusual opportunity to 
affect them for good or evil. Small salaries and incompetent, 
untrained men will, to be sure, enable the state to save money for 
the present and at the same time hold the prisoners under close 
surveillance, but the reformation of character and the prevention 
of crime in the long run is cheaper and should be the object of 
the state. One of the most important factors in the rehabilitation 
work of penal and correctional institutions is the guard, who 
comes into close daily contact with the prisoners. He should be 
selected with care and paid well. 

There is very little we can say to show this institution is 
reforming character and making better men and women out of 
the individuals who are sent to it. Its organization shows no 
signs of having been based upon a well thought out plan for 
protecting society from dangerous criminals who are suffering 
from mental disease or feeblemindedness, or for returning to 
society well adjusted men and women, prepared to take their 
positions as normal members of the community. A certain pro- 
portion of the inmates of this institution will always be a burden 
and a menace to society and need permanent segregation because 



29 

of mental conditions; others, if carefully selected and properly 
trained along occupational lines, may later be returned to the 
community under parole and supervision, and if suitable em- 
ployment is secured and they are frequently visited and care- 
fully tided over the stress of early release, they may never relapse 
into antisocial conduct. 

Certain outstanding needs present themselves in the considera- 
tion of this institution. In the long run it might prove more 
profitable (certainly in the matter of preventing crime) to devote 
more attention than is now given to training the inmates inten- 
sively along vocational lines in order that they may be fitted 
adequately to support themselves at some useful occupation when 
returned to the community. 

The placing of each individual at work in the industries or 
on the farm should be determined only after a careful physical 
and mental examination and a careful study of his abilities and 
his vocational aptitudes have been made. Proper clinical facilities 
should be developed so that all inmates may receive routine phy- 
sical and mental examinations. 

There should be a separate building for the women inmates. 

We would recommend that after an individual study of each 
inmate, all normal-minded and healthy-bodied prisoners be re- 
tained at the main institution and trained in the various indus- 
tries. A variety of industries should be developed, not only for 
the sake of the income to the state, but — what is far more 
important — for the training of the prisoners along occupational 
lines. 

The untrainable as well as the older criminals should be placed 
on the farms, while the sick should receive the most careful and 
modern medical treatment in the hospitals. 

County Jails. ' 

The following jails were included in this survey: Anderson 

County Jail, Charleston County Jail, Florence County Jail, 

Kershaw County Jail, Lexington County Jail, Pickens County 

Jail, and Richland County Jail. 

There were 234 inmates in the above listed jails at the time of 

our survey — 219 men and 15 women; 76 white persons and 158 

colored. 

The actual ages of the jail inmates ranged from 8 to 63 years 



30 



inclusive. There were 39 individuals who were under 18 years 
of age. It is needless for us to go into a discussion of the serious- 
ness of handling children in jails with adult criminals. Forty- 
seven and eight-tenths per cent of these individuals were repeated 
offenders, individuals who had served previous sentences, who 
had been in and out of court time and time again, old criminals. 
By placing children in these institutions we are manufacturing 
criminals rather than preventing crime. 

One hundred and thirty-two or 56.4 per cent were single ; 80, or 
34.2 per cent were married ; 9, or 3.8 per cent were widowed ; 3 or 
1.3 per cent were divorced, and 10 or 4.3 per cent were separated. 

The following table shows the mental diagnosis of the 234 
inmates of these county jails. 



TABLE XI.— MENTAL DIAGNOSIS OF INMATES OF COUNTY JAILS 




Diagnosis 


Total 


White 


Colored 


Normal 




50 
m 46 

52 
t 14 

32 

21 


15 

12 

13 

3 

8 
15 

'4 
6 


35 


Dull normal 

Subnormal 


f 


34 
39 


Borderline mental defect 

Mental defect 


:::v.9f.i£" 


11 
24 


Psychopathic personality 




6 


Psychoneuroses and neuroses 


1 
4 

7 
7 


1 




4 


Mental disease or deterioration 

Unascertained 


::::::::::#: 

i 


3 

1 


Total 


234 


76 


158 



Fifty-six per cent of the inmates of the county jails studied 
were handicapped by some abnormal mental condition, either 
subnormal mentality, mental defect, epilepsy, psychopathic per- 
sonality, or mental disease. 

Eight of the white and 24 of the negro population of these jails 
were feebleminded. Four white persons and three colored were 
insane. 

The Kershaw County Jail, located at Camden, is a brick and 
concrete building in good repair. There is no provision in this 
institution for the segregation of young from older offenders, no 
special provision for the sick or those suffering from contagious 
diseases, no facilities for the determination of mental cases. The 
sheriff receives sixty-five cents a day for each prisoner, out of 
which he has to provide the food. There are no provisions for 
the employment or training of the inmates or for their amuse- 
ments. They are kept in idleness. There is no attending phy- 
sician. , 



31 

The Florence County Jail is a good brick and concrete building 
erected in 1916. The lighting, heating, and water supply, sewage 
disposal, and ventilation are all good. The building is fireproof. 
There is provision for segregation by sex, by age, by race, and 
of witnesses from offenders. There are two separate rooms for 
the sick, one for the colored and one for the white, but no hospital 
equipment or nursing facilities. There is an attending physician 
who receives a salary of $600 a year and comes when called. 
There are no facilities for mental examinations. If any of the 
prisoners are found to be insane, they are not retained longer 
than the time required for commitment. The sheriff is allowed 
fifty cents a day for each prisoner, out of which he is to provide 
the food. There are no provisions for employment or amuse- 
ments, and no special arrangements are made for training.. 

The Lexington County Jail is located at Lexington. This 
building is a good brick building, well lighted and heated. The 
water supply is from a tank. The ventilation consists of four 
win'dows. The section of the jail for colored prisoners is very 
dirty. There is no special fire protection, and no provision for 
segregating young from old offenders or for separating wit- 
nesses from criminals. If a women is sent to the jail, she is 
kept locked in her cell. No provision is made for the sick. In 
case of illness the county physician is called. There are no 
means for separating prisoners with contagious diseases from the 
others. The jailer receives fifty cents a day to feed each prisoner. 
If an insane person is sent to the jail, two physicians are at 
once called and the patient is sent on immediately to the hospital. 
The provisions for bathing are poor, and the bed clothing is not 
clean. There are no screens in the kitchen or in the rest of the 
building as a protection against flies. There are no provisions for 
the employment or training of the inmates and none for amuse- 
ments. 

The Pickens County Jail, located at Pickens, is a brick build- 
ing, dimensions 60x60, and erected in 1904. It is lighted by 
electricity and heated by stoves. The city water system does 
not extend to the jail, which is supplied from a private well, 
but it is expected that by January 1922 there will be city water. 
The sewage disposal is by a private system into a stream 300 
yards away. The jail is clean and well ventilated. There is no 
provision for segregating young offenders from old, and wit- 



32 

nesses are kept in with the regular offenders, but negroes are 
separated from the white inmates. No provision is made for 
segregating prisoners with contagious diseases, and there is no 
special provision for handling the insane, who may be detained 
awaiting commitment. There is only one bath tub in the jail. 
Federal prisoners are allowed thirty-five cents a day for food, 
and county prisoners seventy-five cents a day. There is a large 
room in which inmates are placed if they are sick. There is no 
attending physician. No provisions are made for amusements, 
religious services, employment, or training. 

The Charleston County Jail, located in Charleston, is a build- 
ing constructed of brick and cement. It is 150 years old, but is 
in good repair. It has been remodeled, has cement floors and 
ceilings, and new toilets and baths have been installed recently. 
It has electric lights steam heat, city water, toilets in each cell, 
good ventilation, and is kept very clean. The fire protection is 
fairly good. Young offenders are separated from old offenders, 
negroes from whites, and males from females, but there are no 
provisions for separating witnesses from offenders. There is 
no provision for the sick and no hospital facilities. There is a 
regular jail physician. The food is good both in quantity and 
quality and is served in the cells, there being no dining room. 
Religious services are held every Sunday. There is no provision 
for amusements or recreation. The employment is on the chain 
gang. This is meted out by the courts and not at the direction 
of the jailer. The discipline is excellent. 

The Anderson County Jail, a brick and concrete building, 
75x50, is located at Anderson. It is 21 years old and in excellent 
repair. There are electric lights, steam heat, city water, city sew- 
age disposal, and the ventilation is fair. The jail is not particu- 
larly clean. It is fireproof. There is proper segregation by sex 
and color, but no provision for separating young from old offen- 
ders or witnesses from criminals. There are padded cells for the 
insane, who are not supposed to be kept in the jail longer than 
necessary to have physicians make out commitment papers to the 
State Hospital. There are no special hospital provisions for the 
sick. A regular attending physician is called. (His compensation 
is $450 a year which includes his services to the county home and 
the chain gang as well. If contagious diseases are detected, 
the inmates are sent to the county hospital. The prisoners eat 



33 

in their cells. All the windows are screened, and there are four 
toilets, two showers, and three bathtubs in the jail. The food 
is fairly good. Fifty cents a day is allowed for the food of 
each prisoner. There are no provisions for amusements or em- 
ployment and training inmates. 

The Richland County Jail, located at Columbia, is constructed 
of cement, steel, and concrete.. It was built in 1915. It has 
electric lights, steam heat, city water, and city sewage disposal. 
It is well ventilated and is very clean. The building is fireproof. 
No children are received in this institution, all juvenile cases 
being placed in the detention home. There is segregation by 
sex and race, and of witnesses from offenders. There is a 
regular hospital room, and a regular jail physician, whose 
compensation is $75 a month. Contagious diseases are sent to 
the city hospital. There are padded cells for the insane, who 
are kept until the State Hospital sends for them. The jail 
physician and one outside physician examine the insane and fill 
out commitment papers. Religious services are held on Sunday. 
There are no provisions for amusements or for the employment 
and training of inmates. 

All sentenced prisoners should be committed to the institu- 
tions especially equipped to meet the particular problems pre- 
sented by each individual criminal. County jails should give 
place to houses of detention for those awaiting trial. These 
latter institutions should be built to fulfill the purpose for 
which they are intended — to serve as detention places. The finan- 
cial saving is obvious. One or more counties could unite in the 
building of detention houses for prisoners awaiting trial. Sen- 
tenced prisoners would then go to state or district institutions 
where they could be trained and kept in useful employment and 
something could be done to bring about their reformation. In 
South Carolina, according to law, prisoners cannot be sentenced 
to county jails. These institutions are supposed to be used only 
for those awaiting trial. Sentenced prisoners go either to the 
chain gang or to the State Penitentiary. 

Juvenile Court, Columbia. 

Seventy children, a "run of the mine" of the Juvenile Court, 
are included in this study. Forty-one of these children were 
white and 29 colored; 43 were males and 27 females. Their 
chronological ages ranged from 5 to 20 years inclusive. All of 



34 



these children were American born; 4 had foreign-born fathers 
and 3 had foreign-born mothers. In two instances both the 
parents were foreign born. 

The offenses for which these children were brought into court 
were as follows: stealing, 12; sex offenses, 2; fighting, 5; delin- 
quency and incorrigibility, 4; disorderly conduct, 11; dependent 
or neglected child, 23: truancy, 11 ; and unascertained, 2.Twenty- 
nine children, or 41.4 per cent of the number studied, had been 
arrested more than once, some of them a great many times. 

The degree of mental retardation is shown in the following 
table : , 



TABLE XII.-CHR0N0L0GICAL AGE OF CHILDREN 

TO TEST AGE. 


CLASSIFIED 


WITH 


REFERENCE 


Test Age 


Total 


5 


7 


8 


9 


10 


11 


12 


13 


14 


15 


16 


17 


18 


20 


V years and under 


4 
4 
5 

13 

16 
3 

12 
1 
4 
2 
3 
1 
1 
1 
1 

70 


3 


1 










1 


....LA... 








.... 


2 


2 

1 
2 

1 
























"'3 


1 
1 
1 


2 
1 
3 


1 
1 
3 


















2 
4 
3 
4 


1 
2 


1 


1 
2 










































2 


3 




1 


2 














1 


1 
1 
1 












/ 


1 




1 


1 










XIV years 
















1 




XVI years 


















1 


2 






XVn years 




















1 






Adult 


























1 


Unascertained 


1 



4 


1.... 


























Total 


J 


1 

3 


1 


s 1 


1 

14 


1 

7 


1 

3 


— i 

6 


J 


J 


1 













Four individuals were one year advanced mentally; 1 was 
two, and 1 three years advanced. Ten were retarded 1 year; 
11 two years; 11 three years; 8 four years; 6 five years; 3 six 
years ; 3 seven years ; and 2 eight years. 

The results of the mental examination are shown in the follow- 
ing table: 

TABLE XIII.— RACE OF CHILDREN CLASSIFIED WITH REFERENCE TO MENTAL 

DIAGNOSIS. 





! 


Tota 




1 

White 

1 




Colored 


Diagnosis 


M 


F 


T 


M 


F 


T 


M 


F 


T 




18 
3 

. 9 , 

5 
4 
1 
1 

1 

43 


5 
9 

... 

5 
3 

.... 

27 


23 


m 


3 


13 
7 
6 
1 
7 
5 
1 
.... 

41 


8 
2 
6 


2 
3 
2 


10 


Dull normal 

Subnormal 


12| 1 6) 


5 
8 




10 
i 1 

1 

1 

70 


4| 3 

4) 1 

1 .... 


1 


2 
2 


3 




2 








.... 


16 


1 




1 






Total 


18 


11 


?,9 











35 

Fourteen and three-tenths per cent of these children were found 
to be mental defectives. Fifty per cent of the children were 
handicapped by some abnormal nervous or mental condition, a 
fact that should be borne in mind in dealing with these individ- 
uals. It is important to know whether a child passing through the 
juvenile court is mentally defective, subnormal in intelligence, 
handicapped by psychopathic personality, suffering from epil- 
epsy or psychoneurosis, or is begining to develop psychotic 
trends. However, the study of an individual delinquent should 
not end with the determination of his classification. A compre- 
hensive investigation of all the causative factors that enter into 
his behavior should be made, factors extrinsic as well as in- 
trinsic, factors in his home, in his environment, as well as within 
his own physical and mental make-up; above all it is desirable 
to determine what abilities there are that can be used profitably 
in adjusting the child to normal behavior. 

Approximately 50 per cent of the children included in this 
study had shown other behavior difficulties in their careers than 
those that brought them into court. This is significant for it 
means that in a fairly high per cent of cases, we are dealing 
with children who have repeatedly shown disorders of conduct. 
Forty-eight and a half per cent showed character defects and 
personality handicaps which, aside from any question of degree 
of intelligence, must be regarded as important factors in their 
delinquent conduct. 

Fifty per cent of the children examined showed some physical 
defects, such as defective teeth, eye defect, ear defect, glandular 
enlargements, poor nutrition and the like. 

There is only one juvenile court in this state and that is in 
Columbia. The juvenile court is probably society's most impor- 
tant outpost for the prevention of crime. Here the majority of 
all criminals get their first contact with the machinery society has 
created for the maintenace of law and order and the protection 
of the public welfare. What the court does or fails to do for these 
individuals will show in their future conduct. 

The great majority of criminal careers begin in childhood. 
Prevention of crime largely depends upon our ability to organize 
adequate social forces to deal with the conduct disorders of child- 
hood. Every juvenile court should be equipped with two im- 
portant pieces of machinery: 



36 



(a) Clinical facilities to determine the needs of each indi- 
vidual child, to undertake a scientific inquiry into the 
causes for his socially unacceptable behavior, and to 
map out a plan for the most approved treatment and 
social adjustment. 

(b) A social service staff adequately manned to carry out, 
in the case of each child, the treatment mapped out in 
the clinic (well trained probation officers). 

Those specialized problem cases requiring institutional care 
will, from time to time, present themselves in the court. Some- 
thing of the equipment of such institutions for dealing with these 
problems will now be taken up. 

Fairwold Industrial School for Colored Girls, Columbia. 

At the time of the survey, there were 19 single girls in this 
institution, all supposed to be free from venereal disease. Their 
chronological ages ranged from 11 to 17 years inclusive. They 
were all negro girls, American born. Seventeen were born in 
South Carolina. The parents of all the girls were American 
born. Sixteen of these girls were committed for incorrigibility, 
1 for waywardness, and 2 for stealing. 

The following table shows the degree of mental retardation : 



TABLE XIV.- 


-CHRONOLOGICAL AGE OF INMATES CLASSIFIED WITH 
TEST AGE. 


REFERENCE 


TO 


Test Age Total 


11 


13 


14 


15 


16 


17 




4 
5 
4 
2 
1 
3 

19 


1 
2 


1 




1 

2 

.... 

1 


1 

1 
1 

1 

"3 

7 




Vm years 








1 


1 


1 
















Xm years 
Total . 














3 


2 


1 


«i 


1 











There were 7 children three years retarded mentally; 3 four 
years; 1 five years; 2 six years; 3 seven years; 2 eight years; 
and 1 nine years. 

TABLE XV— PHYSICAL CONDITION OF INMATES CLASSIFIED WITH REFERENCE TO 

MENTAL DIAGNOSIS. 



Diagnosis 


Total 


Good 


Fair 


Poor 




7 
1 
2 


4 
1 


3 










2 









37 



TABLE XV.— PHYSICAL CONDITION OF INMATES CLASSIFIED 
MENTAL DIAGNOSIS.— Continued. 


WITH REFERENCE TO 


Diagnosis 


Total 


Good 1 Fair 


Poor 




2 
3 
2 
1 


1 

i" 


1 
1 

1 






2 








1 




1 






1 


Total 








19 


7 


8 


4 







, Three of these girls were feebleminded and 2 were classified 
as borderline mental defectives. Four girls were in poor physical 
condition, and fifteen out of the 19 showed very definite defects 
and handicaps in their personality make-up. The cause for ad- 
mission in each case was delinquency. 

This institution is located at Columbia on a tract of land in- 
cluding about thirty acres. The age limits are from 11 to 17 
years. 

Expenditure for the maintenance of this institution during 
the last fiscal year was approximately $10,000. The income 
is derived solely from donations. The institution consists of 
two small frame cottages in good state of repair. There is no 
dining room and no school room. The girls eat in the kitchen. 
The institution is governed by a board of managers consisting of 
both white and colored persons. This board is a perpetuating 
body. Under the board is a superintendent who receives $900 
per year and maintenance. There are also an assistant superin- 
tendent and a matron. There is an attending physician, and 
each girl receives a physical examination before admission. No 
girl having a venereal or contagious disease is admitted. There 
is no provision for mental examination. The teaching is done 
by the superintendent and assistant superintendent. The bath- 
ing and toilet facilities are exceedingly poor. 

On the whole the institution officials are bravely endeavoring 
with poor equipment to do a much needed piece of work in sal- 
vaging colored girls. Another building is needed badly, before 
any educational and industrial training can be given these girls. 

Industrial School for Girls, Columbia. 

There were 22 girls in this institution at the time of our visit, 
all of them white, and all American born. Their parents were 
also American born. The girls ages range from 11 to 18 years 



38 



inclusive. Fourteen of these girls were committed for incor- 
rigibility, 2 for vagrancy, 4 for running away from home, and 
2 for sex offenses. Four out of the 22 girls were repeated 
offenders. 

The relationship of the mental age to the chronological age 
is shown in the following table : 



TABLE XVI— CHRONOLOGICAL AGES OF INMATES CLASSIFIED WITH 

MENTAL AGE. 


REFERENCE 


TO 


1 
Mental Age Total 


11 


12 


13 


14 


15 


1 1 

161 17| 18 

1 1 




f> 




1 


j 






1 

1 






1 
4 
1 
2 
3 
1 
1 
3 
4 

22 


















1 


1 


.... 


1 


1 


















1 

1 




1 




XIII years 








1 


1 




XV years 


1 






















1 
1 
1 

6 










1 






1 
1 

4 




Adult 




1 


1 


Total 


1 


1 


2 


3 


?! 













There were 2 children one year retarded mentally; 2 two 
years retarded; 2 three years; 3 four years; 1 five years; 1 six 
years ; 2 eight years ; 1 nine years ; 1 was one year advanced ; and 
2 four years advanced. 



TABLE XVII.— PHYSICAL 


CONDITION OF INMATES CLASSIFIED 
MENTAL DIAGNOSIS. 


WITH REFERENCE TO 


Diagnosis 


Total 


Good 


Fair 


Poor 




6 
2 
2 
2 
4 
6 


4 
1 

1 

3" 

3 


1 
1 

1 
1 

""2" 


1 












1 




1 




1 








Total 


22 


12 


6 


4 







It will be seen from this table that there were 4 feebleminded 
girls in the group and 2 were classed as borderline mental 
defectives. 

Fourteen out of the 22, more than one half of the girls, were 
either definitely subnormal in intelligence, mentally defective, 
or suffering from psychopathic personality. 

This institution is located near Columbia on a tract of ap- 
proximately 600 acres of land. Between five and ten acres are 



39 

in cultivation, eight to ten in pine woods and the rest is grazing 
land. Enough fruit and vegetables to supply the needs of the 
institution are raised on the place. 

At the present time there are two cottages, one finished and 
one unfinished. It is estimated that approximately $10,000 
would be required to complete this latter building. It has been 
standing in this unfinished stage for about one year because of 
lack of funds. (Since this inspection was made the unfinished 
cottage has been completed). 

The finished cottage takes care of 22 girls and 7 officers. It is 
two and one half stories high and is built of brick. There is 
a clinic and operating room on the first floor with adequate 
equipment to perform minor operations. There are an office, 
a dining room, a kitchen, a laundry, and four sleeping rooms 
on the first floor. The second floor consists 19 rooms, of which 
14 are individual bedrooms. The third floor is composed of 
of one large room which is used for a school room. 

The cottage has steam heat, running water, and is lighted 
by the Delco system. The unfinished cottage is built practically 
on the same plan. 

The governing authority of the school is the State Board of 
Public Welfare. This board appoints the superintendent, whose 
salary is $1,800 and maintenance. 

There is no provision for the segregation of the younger girls 
from the older girls, but living conditions are very good and 
homelike, the food well selected and nourishing. 

There are three teachers. The academic training consists 
of regular grade work from the first to the eighth grade in- 
clusive. Industrial and vocational training are given. The 
regular domestic science course, general housework, dressmaking, 
gardening, chicken raising and dairying are all taught. 

Provision for amusement and play are inadequate. The li- 
brary consists of approximately 500 volumes. 

The health of the girls is in the care of a woman physician, 
who, however, is not resident, but comes only upon request. A 
fairly complete physical examination is given to each girl upon 
entrance, including blood tests for syphilis and smears for 
gonorrhea. In many instances a test for hook worm is given. 
No medical records are kept in the institution. 



40 

A psychological examination is given to each girl by the 
psychologist of the State Board of Public Welfare. 

There are no parole officers or social workers to do any 
follow-up work, or to supervise the girls that are returned 
to the community. The return of delinquent girls to the com- 
munity is a far more difficult and serious problem than that 
of delinquent boys. The period of stay in the state institution 
is only preparatory to the measures that the state should employ 
for dealing with delinquent girls. 

Recommendations. 

1. Provision should be made for a receiving cottage. All 

newly admitted girls should be retained here for a suffi- 
ciently long period to determine the type of problem 
they present. In this way the danger of the introduc- 
tion of epidemics could be avoided. Not only physical 
contagion, but moral cantagion is a problem to be caii- 
sidered. Those girls, who are making progress in build- 
ing up their own characters, should be protected from 
contamination. 

2. A school building is needed. This should include not 

only suitable provision for the regular class rooms re- 
quired in grade teaching, but rooms for the industrial 
and vocational training which should be highly de- 
veloped and stressed at this institution. The girls should 
be taught something at which they can earn a good 
living. In the school building provision should be made 
for a gymnasium as well as a chapel. There is need for 
another teacher. 

3. A model dairy building is needed. 

4. Proper follow-up work and after care of the girls that 

are returned to society. This is one of the largest and 
most important pieces of work to be done in dealing 
with delinquent girls. 

5. An adequate case-record system, without which no intelli- 

gent procedure can be planned either for the treat- 
ment and training of each girl or the return, super- 
vision, and final adjustment of her in the community. 

State Reformatory for Negro Boys, Columbia. 
There were 151 negro boys in this institution at the time of 



41 



our visit. They ranged in years from 8 to 20 years inclusive. 
They were all American born. Approximately 91% were born 
in South Carolina. All the fathers and all the mothers of these 
boys were also American born. One hundred and eight of 
these boys had been committed for offenses against property — 
stealing, breaking and entering, burglary, etc., 3 for sex offenses, 
2 for assault and battery, 21 for incorrigibility, 7 for man- 
slaughter, and 10 for miscellaneous charges other than those 
mentioned. Forty-three per cent of them were repeated offen- 
ders, individuals who had previously been arrested, some of 
them many times. 

TABLE XVIII.-CHRONOLOGICAL AGE OF INMATES CLASSIFIED WITH REFERENCE TO 

MENTAL AGE. 



Mental Age. 



Total 



11 1 12 113 1 14 1 15 1 16 1 17 1 18 1 19 1 20 ( Unascertained 

' I I I I I 11 ' 



Under Vn ... 
VH years — 

VIII years 

IX years 

X years 

XI years 

Xn years 

Xm "years ... 

XIV years . . 

XV years . . . 
Unascertained 



H 
.. 1 



Total i 151 

I 



1 2 



9|16|22|33|40|13 
Mill 



2 1 
I 1 

I 1 

I 1 



81 4| 2| 
I I' 1 



Seventy-seven and four-tenths per cent, or more than three 
out of every four, of the inmates of this institution had an I.Q. of 
less than 80, while approximately 35%, more than 1 out of every 3, 
had an I. Q. of less than 60. 

TABLE XIX.— MENTAL DIAGNOSIS OF INMATES. 



Diagnosis 


Number 


Per Cent 




3 2 
27 
36 
16 
31 
6 
3 


21 2 




17 9 




23.8 




10 6 




20 5 




40 




2 








Total 


151 


100 







Twenty and five-tenths per cent of these boys were classified 
as feebleminded. Almost 60% were either abnormal in intelli- 
gence, mentally defective, feebleminded, or handicapped by 
a psychopathic personality. Sixty per cent of the inmates 



42 

showed some handicaps in personality make-up, marked defects 
in character, which are certainly important to consider in 
connection with their conduct. 

Forty per cent of the boys had some physical defect either 
of the eyes, ears, teeth, glands, or the like. 

This institution is located 6| miles northwest of Columbia 
on a tract of land containing 593 acres. One hundred and forty 
acres are in woodland and pasture, and 453 are in cultivation. 
This is principally planted in cotton, wheat, and garden vege- 
tables. 

The governing authority for the institution is the State Board 
of Public Welfare, which appoints the superintendent, whose 
salary is $1,800 a year and maintenance. 

Any negro boy 16 years or under, who commits any offense 
that may be punishable by imprisonment in the State Peniten- 
tiary, can be sent to this institution. 

The inmates are housed in a three-story brick building. The 
first floor contains a kitchen, a mess hall, a small day room 
for the gardeners; and a guard's toilet. The second floor 
contains a dormitory with 52 beds, in which sleep 68 boys, a 
guard's sleeping room, a bathroom containing shower baths, 
and toilets for the inmates. The third floor contains a dormitory 
for younger boys in which are 55 cots. In these 79 boys sleep. 
There is also one guard's room, a bath room containing shower 
bath and toilet facilities. 

There are two wooden barns, a two story wooden building 
for gin house and grist mill, containing a cotton gin and a 
tw T elve-horse-power steam engine; a cow barn, a crib and barn 
combined ; two other barn buildings ; a one-story wooden building 
with three rooms used as guards' quarters ; a brick building which 
is used as a boiler room, with a forty-horse-power engine ;a 
steam pump for pumping water for the entire plant; an upright 
engine for driving laundry equipment; one washing machine; 
and one extractor. A one-story wooden building is used for 
shoe-shop and manual-training quarters. A two-story wooden 
building serves as school and hospital; the first floor contains 
two schoolrooms in which 50 modern desks have been installed; 
the second floor is used as a hospital. There is little here to 
justify the name; however, it is hoped that money will be 
provided so that in the near future this building can be remod- 
eled and equipped with some modern provision for the sick. 



No physical examination is made upon entrance, and blood 
tests are made only on suspected cases. There is no provision 
for mental examination, no means for detecting the mentally 
defective and mentally sick. An attending physician, employed 
at a salary of $1,200 a year, comes on request when there is illness 
among the inmates. No medical records are kept. 

There are a few additional wooden buildings which house a 
Delco lighting system and are used for various other purposes. 

There are two school rooms, each of which is in charge of a 
colored school teacher, and each has three grades. The small boys 
are taught for two sessions a day twelve months in the year. 
The older boys go to school two sessions a day for at least six 
months in the year. The institution has no library. 

There is a limited amount of manual training. An up-to-date 
Goodyear repairing system has recently been installed, and 
small numbers of the boys are being taught how to repair shoes. 
It is planned that in the near future the boys will be taught how 
to build shoes. They will buy the uppers and make their own 
soles and then construct the shoes. 

Farming is the chief occupation of the inmates. The insti- 
tution owns a dairy herd and has made a fair beginning in the 
raising of pigs and other live stock. 

Recommendations. 

1. An additional dormitory building is badly needed. There 
is overcrowding. This building should be of the cottage type. 
Younger boys should be segregated from older boys. 

2. A school building should be provided. This building 
should contain rooms, not only for academic and vocational 
training of inmates, but for physical training. 

3 Modern hospital facilities are badly needed. 

4. Routine physical and mental examination of all individ- 
uals on admission. 

5. A modern case-record system, which would contain case 
histories with important information on each individual inmate. 

6. A parole officer to keep in touch with and supervise parole 
boys in the community. 

7. There is need for an up-to-date dairy equipment, so that 
the milk can be handled in a sanitary way. 



44 



Industrial School For Boys, Florence. 

There were 161 boys at this institution. Their ages ranged 
from 9 to 21 years inclusive. They were all American born. 
In three instances the fathers were foreign born, and in two 
instances the mothers were foreign born. Forty-one of the 
inmates were committed for offenses against property — stealing, 
etc.; 1 for sex offenses; 1 for assault and battery; 104 for 
incorrigibility; 7 for dependency; 1 for manslaughter; and 6 
for various other offenses. Fifty-three and four-tenths per 
cent of the boys of this institution were repeated offenders. The 
intelligence rating is shown in the following table: 

TABLE XX.-CHRONOLOGICAL AGES OF INMATES CLASSIFIED WITH REFERENCE TO 

TEST AGE. 



Test Age 



Total 

I 1 I 



13 14 15[ 16 

) i 1 i 



17 



18 



19 
and 
Over 



VI years . . 

VII years . . . 

VIII years . . 

IX years . . . 

X years 

XI years 

XII years . . . 
Xm years .. 

XIV years ... 

XV years . . 

XVI years . . 

XVII years . 
Unascertained 



Total 



161 



12 



26 



40 



22 



There were 7 children at age; 7 one year retarded; 16 two 
years; 21 three years; 16 four years; 16 five years; 23 six years; 
13 seven years; 8 eight years; 4 nine years; 2 ten years; and 
1 eleven years retarded; 2 one year advanced; 3 two years and 
1 three years advanced. 

TABLE XXI.— MENTAL DIAGNOSIS OF INMATES. 



Diagnosis 


Number 


Per Cent 




37 
29 
28 
20 
32 
12 
1 
2 


23.0 




18.0 




17.4 




12.4 




19.9 




7.5 




0.6 




1.2 








Total 


161 


100.0 







Nineteen and nine-tenths per cent of the boys in this institution 



45 

were feebleminded, while an additional 12.4% were considered 
borderline mental defectives. This shows a very high frequency 
of mental defect. Sixty-four per cent of all of these inmates 
had character defects and marked handicaps of personality 
of such a nature as to influence their conduct. 

Eighty-seven per cent showed physical defects. These defects 
include defective vision, defective teeth, defective hearing, gland- 
ular enlargement, heart conditions, poor nutrition etc. 

The institution is located at Florence, South Carolina, on a 
tract of 562 acres, 236 of which are under cultivation. The 
institution is on the cottage plan. The four buildings of brick 
and concrete are modern and well constructed. 

The governing authority is the State Board of Public Welfare, 
which appoints the superintendent to serve at its pleasure. 

There is no resident physician. During the summer months 
a medical interne is in attendance at the institution. Every boy 
is given a physical examination on entrance, which includes 
blood test for syphilis and smears for gonorrhea. The hospital 
facilities are most inadequate. There is a medical ward located 
above the kitchen and dining room of one of the buildings, and 
a separate room on this floor for contagious diseases. After 
the first examination on entrance, there are no further exami- 
nations except in the case of illness. 

There is no routine and complete mental examination of the 
inmates with the exception of the fact that two or three times 
a year selected cases are chosen for psychological examination 
by the psychologist of the State Board of Public Welfare. 

The records in the case of each child are very incomplete 
and contain little data upon which a comprehensive program 
for the treatment, training, and social adjustment of individual 
delinquents can be based. 

There are five teachers, one of whom is the principal. There 
are class rooms in each cottage, there being no separate school 
building. The academic training consists of the regular grade 
work from the first to the eighth grade inclusive. The equip- 
ment for manual training is very good. 

After the study of each child's aptitudes and interests, he 
is placed in printing, dairying, cooking, baking, farming, laundry 
work, etc. There is no gymnasium or special physical training 
other than the company drill each morning. 

There is a brass band with a special musical director. 



46 

The amusements consist of baseball and general playground 
games. The playgrounds are under the supervision of the 
company officers. 

The institution has about 200 books to which the boys have 
access. 

The conditions for a parole are a suitable home environment 
and a satisfactory record at the institution, but there are no 
parole officers or social workers attached to the institution. 
Institution life is, at best, only artificial. The most serious prob- 
lem in connection with the delinquent child is in his readjusment 
to society after he leaves the institution. The period of his 
release and return to the community is one of great stress 
and is fraught with grave danger to the boy himself and to 
society in general. The selection of associates, the adjustment 
into the daily life of the home, the securing of suitable employ- 
ment, the provision for amusement and play, all have much to 
do with the question of his future conduct. Carefully chosen, 
properly trained parole officers are among the the most valuable 
tools the state possesses for the prevention of delinquency. 
Supervision and follow-up work of these children is essential. 
There is special provision made for the segregation of young 
offenders from old offenders. Children under twelve years of 
age are placed in one cottage, those between twelve and fifteen 
in another, while all children over fifteen years are grouped in 
still another. 

There are three recommendations that we wish to make: 

1. Proper follow-up work and after care. The institution is 
doing only half its job in not having proper parole officers to 
supervise the children paroled into the community. 

2. Proper hospital facilities. The foundation for the hos- 
pital has been laid and many supplies purchased, but work on 
the building was stopped because of lack of funds. This should 
be completed, as the present facilities are most inadequate. 

3. Routine mental examination of all boys, not only for the 
determination of those who are mentally defective, but (and 
this is more important) to outline the abilities and aptitude 
of each child and to map out a plan of treatment and training. 

GENERAL DISCUSSION OF DELINQUENCY. 

It must be borne in mind that this was a mental- deficiency 
survey, the aims and purposes being to ascertain something 



47 

of the problem feeblemindedness presented to the state of South 
Carolina. The foregoing tables of mental diagnosis and other 
data are not presented with the idea that they indicate the essen- 
tial causative factors underlying delinquency. 

The writer does not believe that the simple mental classifica- 
tion of individuals gives a great deal of information about 
criminals and why they act as they do. There are many and 
varied causes for delinquent or non-delinquent conduct in indivi- 
duals, whether they be feebleminded, normal, mentally dis- 
eased or what not. It was not the object of this survey to go into 
these questions. We do wish, however, in the following discus- 
sion, to bring out and emphasize some points that we feel are well 
worth stressing in connection with a program for dealing with 
delinquency. 

In all of the institutions included in the above study, beginning 
with those handling the youngest juveniles and continuing 
up to the state prison, we found evidence of repeated criminal 
conduct. 

In all of these institutions, time and time again we ran 
across offenders who had been arrested over and over and had 
served many sentences. 

From 25 to 50% of all individuals found in delinquent and 
penal institutions are repeated offenders. This is a serious 
challenge to our methods of dealing with criminals. It has been 
estimated that crimes by men with prison records outnumber 
crimes by other offenders more than 40%. 

The whole business of sentencing an individual for a definite 
period is not based on common sense. It is pure guess work to 
try to say whether a man can reform in a given time. Our atti- 
tude of dealing with criminals is still, in a large measure, one of 
vengeance. It is a fact that we take no account of individual 
differences and of the causes that lead an individual to commit 
criminal acts. We are still held down by the old conception of 
responsibility. If a man is sane, then he is responsible and 
should be punished. 

Our sentencing of offenders to penal and correctional institu- 
tions for limited periods without any reference to the causes for 
their criminal conduct — causes found within the individual him- 
self as well as in in his environment — without any reference to 
the needs of the individual offender, if he is to be reformed and 
lead a normal life, is in the same category with sending sick 



48 

people to hospitals and giving them nothing more than kindly 
and humane treatment, sanitary surroundings, good food, and 
then turning them out at the end of an arbitrary period without 
any reference to whether their illness had been cured or not. 

It is believed that success in the handling of criminals and in 
the prevention of crime will depend upon the degree of interest 
we take in developing methods of dealing with delinquent persons 
as individuals and not as groups; for determining the causes 
of their delinquent behavior and for setting in motion machinery 
looking towards the eradication of these causes and the rehabil- 
itation and readjustment of the individual offender. 

The methods mostly in use today for dealing with criminals 
do not give us a knowledge of the individual criminal and why 
he acts as he does. And yet there is ample evidence in many 
fields that scientific methods of inquiry have already been de- 
veloped to a degree sufficient to enable us to ascertain the causes 
of the failure of certain persons to conduct themselves as they 
should. 

These methods have been applied in certain places to dealing 
with delinquents and have resulted in great improvement in the 
treatment and prevention of crime. 

It is believed that the application of scientific methods of 
investigation to the study of every delinquent, juvenile and adult, 
before disposition in court, and the mapping out of a plan 
of treatment in the light of this careful and comprehensive 
inquiry, would result in a great reduction in crime. 

If this is our purpose, if the aim in view is to protect society 
and prevent criminal conduct, then we need to get away from 
philosophical theories and face the facts; we need to think less 
of responsibility and vengeance, of wreaking punishment on the 
wrongdoer, and to learn more about what sort of persons 
commit crime, why they behave as they do, and in the light of 
this information to decide what needs to be done to give the 
greatest protection to society on the one hand and to prevent 
future criminal careers on the other. 

Every court should be equiped with clinical facilities for 
making physical, mental, and social diagnosis. There should 
also be a probation staff to carry out treatment, supervision, and 
social adjustment of all individuals who can be handled with 
safety in the community. 



49 

Delinquent and penal institutions should be organized to 
deal in an effective way in educating trade training, and re- 
constructing, physically and mentally, such offenders as are 
sent to them, or in permanently segregating those who cannot 
be returned with safety to the community. 

The type of clinic required to meet the court's problem is 
now generally admitted to include three main fields of ac- 
tivity: PSYCHIATRY, PSYCHOLOGY, and PSYCHIA- 
TRIC SOCIAL WORK. The personnel would be as follows: 
a well trained medical man with special equipment in psychiatry 
to act as director, to be assisted by a psychologist and a 
psychiatric social worker. 

It has now come to be recognized that the great majority 
of criminal careers begin in childhood. The most striking thing 
in the recent crime wave in this country is the frequency of 
crimes of violence committed by very young offenders. 

Early, even in the pre-juvenile court age, manifestations of 
conduct disorders show themselves. Conditions are apparent 
in public school children that lead later on to gross criminal 
behavior. Our previous discussion of conduct disorders among 
public school children brought out the startling fact that ap- 
proximately 7.5 per cent of the white and 13.4 per cent of 
the negro children showed unacceptable conduct of such a nature 
as to come to the attention of school authorities. We called 
attention to this important fact that the danger of entering 
criminal careers is one of the most serious conditions threaten- 
ing childhood. These matters connot be regarded lightly. If 
we are seriously to take measures to prevent crime, there can be 
no period as opportune as this of childhood. The criminals of 
the future, it is believed, will be drawn mostly from those child- 
ren who show marked difficulties in behavior. 

The clinical facilities for the study of the complex behavior 
problems of the juvenile court should be extended to include 
those children showing conduct disorders in the public schools. 
The unraveling of each individual problem will require the 
most expert service. Personal difficulties and unhealthy adap- 
tations, improper home background, nervous and psychopathic 
parents, lack of parental control, bad practices and teachings 
of other children, physical disorders, poorly arranged school 
curriculum, and a great variety of conditions will be found 



50 

entering as causative factors into every case. The most dis- 
criminating, skillful, and sympathetic approach will be required. 

DEPENDENCY. 

Juvenile Dependent Institutions. 

The institutions included in this group are the Orphan House, 
Charleston; Jenkins Orphanage, Charleston; De la Howe 
State School; Rescue Orphanage, Columbia; Epworth Or- 
phanage, Columbia; and City Orphan Asylum, Charleston. 

Orphan House, Charleston. 

There were 218 children included in the survey of the Orphan 
House at Charleston — 98 males and 120 females. These were all 
American-born children, and the majority of the parents were 
American born. Six fathers and 3 mothers were foreign born. 
The ages of the children ranged from 3 to 17 years inclusive. 
They were all white children. The following table shows the 
mental diagnoses of the children of this institution : 

TABLE XXII.— MENTAL DIAGNOSIS OF INMATES. 



Diagnosis 




Number 






Pre Cent 




| Males 


Females 


Total 


Males 


Females 


Total 




51 
1 29 

12 
2 
3 
1 


52 
35 
22 
6 
5 


103 
64 
34 
8 
8 
1 


52.0 
29.6 
12.2 
2.0 
3.1 
1.0 


43.3 
29.2 
18.3 
5.0 
4.2 


47.2 


Dull normal 


29.4 
15.6 


Borderline mental defect 

Mental defect 

Psychopathic personality 


3.7 
3.7 
0.5 


Total 


' 98 


' 120 


' 218 


100.0 


100.0 


100.0 







Only 3.7 per cent were classed as feebleminded. This is a 
strikingly low percentage of mental defect in an orphanage, 
Also, 3.7 per cent were considered borderline cases of mental 
defect. 

This institution is located in Charleston and consists of a main 
building of brick covered with cement. It has 9 dormitories and 
1 nursery, making provision for 250 beds. Each child has a 
single bed to himself. 

There is segregation by sex, the boys occupying one wing and 
the girls the other. 

The institution is under the governing authority of a Board of 



5i 

Trustees appointed by the City Council for a term of four years. 
The board elects a principal and an assistant. 

The source of income is principally from the city government 
of Charleston. The youngest child in the institution was 2 years 
old and the oldest 17 years old. 

The principal appoints the teachers, of whom there are 7. The 
qualifications for the teachers are the same as for public-school 
teachers. 

All the children are given some academic training from kinder- 
garten to the ninth grade inclusive. The girls are taught sewing, 
housekeeping, and cooking, while the boys are given training in 
mattress making, shoe repairing, carpentry, and gardening. The 
provisions for amusement and playground activities are not 
adequate. The hospital facilities consist of 2 wards with an 
operating room and a diet kitchen. No routine physical examina- 
tions are made, but every child, before being accepted, has had a 
physical examination. Blood tests are only made on suspected 
cases. There is no provision for mental examination and no way 
of determining the frequency of feeblemindedness and psycho- 
pathic conditions among the children. 

The library contains 5,522 volumes. The children have free 
access to the books. 

There is no provision for follow-up work and supervision of 
the children who are placed out in the community. It seems to us 
that the institution is doing very good work. 

Jenkins Orphanage. 

This is an institution for negro children and is located at 
Charleston. They receive dependent, delinquent and incorrigible 
children. There were 63 children studied out of 143 in the 
institution at the time of our visit, all American born; 35 of 
whom were born in South Carolina. The parents of these 
children were all American-born negroes. The children's ages 
ranged from 3 to 20 years inclusive. The following table shows 
the degree of mental retardation among these children : 



52 



TABLE XXIII.-CHRONOLOGICAL AGES OF CHILDREN 

TO TEST AGE. 


CLASSIFIED 


WITH REFERENCE 


Test age. 


Total 


3 


5 


6 


7 


8 


9 


10 


11 


12 


13 


14 


15 16 


17 


18 


20 


V and under 


5 
6 
7 
25 
5 
9 
1 
1 
3 
' 1 


1 


1 


i 

1 


1 

"i 

2 


2 

2 


i 
i 

2 


i 

l 
l 

3 


1 

1 

2 

2 

1 

8 


"i 

6 

1 

8 


"i 

5 
'2 

8 


4 

2 
1 

'a 

10 


i 

1 
1 

5 

1 

1 

10 


'2 

i 
3 


i 

1 

2 


i 

1 












VIII veare 


1 










XI years 








XIII vears 




XIV years 








Total 


63 


1 


1 


1 













There are 3 children at age; 5 children one year retarded; 5 
two years; 10 three years; 10 four years; 15 five years; 5 six 
years ; 1 seven years ; 3 eight years ; 2 nine years ; 2 ten years ; 
and 1 eleven years retarded. One child was two years advanced. 



TABLE XXIV.— MENTAL DIAGNOSIS OF CHILDREN. 



Normal 

Dull normal 

Subnormal 

Borderline mental defect 

Mental defect 

Psychopathic personality 
Endocrine disorder 

m ' ■ ; 

Total 



There 7 seven feebleminded children at this institution with an 
additional 10 who were classed as borderline mental defectives. 
Forty-seven children out of the 63 showed some physical defect, 
while 5 children were in such poor health as to be in urgent need 
of medical care. 

Forty-three out of the 63 children showed conduct disorders of 
such a nature as to come to the attention of the authorities of 
this institution. 

At the Jenkins Orphanage one hundred and sixty-five acres 
are in cultivation. Two hundred acres are on a farm which is 
situated 17 miles from Charleston. Nine acres are planted near 
the orphanage. 

Expenditures for maintenance during the last fiscal year were 
$52,632.39. The income is derived from many sources — the City 
Council and various donations. The governing board consists of 
a Board of Commissioners appointed by the mayor. The Ad- 
visory Board is selected by the Orphan Aid Society. The Board 



53 

of Commissioners appoints the superintendent. The present in- 
cumbent is the founder of the institution, the Reverend D. J. 
Jenkins. 

The institution consists of two two-and-a-half story buildings, 
one of wood and one of brick. They are very old and were 
erected before the Civil War. There are four dormitories for 
girls and five for boys. There are 56 single beds for 108 boys and 
26 single beds for 35 girls. The overcrowding is serious. Living 
conditions in the dormitories are poor. There are no mattresses 
and the plastering on the walls has fallen down. There is no 
routine physical or mental examination of these children. A 
doctor is called when necessary. The boys are segregated from 
the girls in different buildings. One of the rooms is used for the 
sick, but there are no adequate hospital facilities. There are 2 
teachers for 143 children. The regular grades are taught from 
the primer up to the seventh grade inclusive. There are also shoe 
repairing, printing, farming, and blaeksmithing for the boys, 
and sewing, laundry work, house work and cooking for the girls. 
There is no provision for amusements or playground activities. 
There is a small library containing 300 or 400 volumes. 

Recommendatioxs. 

1. Proper fire protection. 

2. Plaster the buildings. 

3. Provision for playground activities. 

4. Installation of adequate lavatories and toilets (the girls 

have only one lavatory). 

De la Howe State School. 

There were 20 white children, boys and girls studied, at this 
institution, ranging in age from 8 to 17 inclusive, and all Ameri- 
can born. Sixteen were born in South Carolina. All the parents 
were American born. There were 4 children retarded one year, 
3 two years, 1 three years, 3 four years, 1 five years, 1 six years 
and 2 advanced one year. 

TABLE XXV.— MENTAL DIAGNOSIS OF CHILDREN. 

Normal 8 

Dull normal 6 

Subnormal 2 

Borderline mental defect 1 

Mental defect , 1 

Psychopathic personality 2 

Total 20 



54 

There was only 1 feebleminded child at this institution and 1 
child diagnosed as a borderline mental defective. One-half of the 
children showed physical defects of some character. Nine of the 
children showed conduct disorders of such a nature as to come to 
the attention of the officials of the institution. 

The John De la Howe School was founded by the will of John 
De la Howe, a physician of Abbeville County in January 1797. 
Up to 1918, when the State Assembly took it over, and estab- 
lished it as a state institution, it survived on the income from its 
rented lands. This institution is under the administraton of a 
Board of seven Trustees who are apponted by the Governor with 
the consent of the Senate. 

This school has about 2,000 acres of land, three hundred acres 
of which are in virgin forest. Seven hundred acres are under 
cultivation. There are several tenant farmers to whom a portion 
of the land is leased. 

According to the will of De la Howe, this estate must care for 
12 boys and 12 girls at a time from Abbeville County (as it then 
existed), orphans, other things being equal, to be given the pref- 
erence. 

The purpose of this school is to offer the best possible care and 
training for dependent children who are not mentally defective. 
Illegitimate children as well as children of poor parents, half and 
whole orphans are received. This is the oldest and the smallest 
of the state's benevolent institutions. 

With money appropriated by the State, the new building is 
being erected. When completed it will be 210 feet long, 2 stories 
high, of granite quarried on the estate, and will cost approx- 
mately $150,000. Sixty-two thousand dollars is now needed to 
complete this building and equip it entirely. This building is 
located on a hill about a half mile from the present site. There 
is room on this hill for about 50 buildings, and it is the plan of the 
superintendent to develop the institution on the cottage-plan 
with this new building as the center. 

At present there are 7 buildings in use; a boys' dormitory and 
a girls' dormitory, both of which are in only fair condition, a 
wash house ; a barn and a cow barn in poor condition ; a chapel 
recently converted into a school by partitioning off the audito- 
rium to form two class rooms. This is in fair condition. The 
superintendent's house is in fairly good condition. 



55 



The governing authority of this institution is vested in a board 
appointed by the Governor. The superintendent and physician 
are appointed by the board. The salary of the superintendent is 
$1,800 and maintenance. 

There is no physical examination given children on entrance; 
however, the child must be passed as free from feeblemindedness 
by the psychologist of the State Board of Public Welfare. There 
are no records of any value bearing upon the children. 

There are 3 teachers. Academic training is given up to and in- 
cluding the ninth grade. High school and business courses are 
planned. There is no manual and industrial training. The girls 
assist in the cooking and laundry work and the boys work on the 
farm. There is no special physical training. All amusements are 
self made. There is no library. 

Recommendations. 

This should be made a modern State School for Dependent 
Children with well organized academic, industrial, and voca- 
tional training facilities. The development of the institution on 
the cottage plan, its better equipment, and, finally, the provision 
of parole for suitable cases, are recommended. 

Rescue Orphanage. 

One hundred and twenty-six children were studied at this in- 
stitution — 65 males and 61 females. They were all white chil- 
dren and all American born. One hundred and seventeen were 
born in South Carolina. Their ages ranged from 4 to 18 years 
inclusive. 



TABLE XXVI.— MENTAL DIAGNOSIS OF INMATES. 



Diagnosis 




Number 






Per cent 




Males | 


Females 


Total 


Males 


Females 


Total 




18 
14 

19 
6 

7 
1 


28 
9 
5 
6 
9 
4 


46 
23 
24 
12 
16 
5 


27.7 
21.5 
29.2 

9.2 
10.8 

1.5 


45.9 

14.8 

8.2 

9.8 

14.8 

6.6 


36 5 




18 3 




19.0 


Borderline mental defect 


9.5 

12.7 


Psychopathic personality 


4.0 



Total 



65 



126 



100.0 



100.0 



100.0 



Twelve and seven-tenths per cent were feebleminded, while 9.5 
per cent were classed as borderline mental defectives. One hun- 
dred and three children showed some physical defect, either 



56 

defective teeth, defective vision, defective hearing, or such other 
conditions. Twenty-five children were in such poor health as to 
need medical care. Fourteen children out of this group showed 
behavior difficulties of such a nature as to have come to the 
attention of the officials of the institution. 

We wish to insert a report of this institution made by Dr. G. 
Croft Williams, Secretary of the State Board of Public Welfare. 

The Rescue Orphanage, Columbia, South Carolina, was visited 
July 23 by Secretary G. Croft Williams of the State Board of 
Public Welfare. Dr. Williams reports : 

"There are 119 children in this institution — 54 girls nnd 65 
boys. All of these children appeared to be well and strong, with 
the exception of a little girl that is at the hospital. This or- 
phanage is having a different experience from other orphanages 
of the state in that it is getting more applications from older 
children than it has hitherto received. The ages of admission are 
— girls 12, boys 10 years. 

"The medical supervision of the inmates is under Dr. Cornell 
of Columbia, who visits the orphanage once a week. Other phy- 
sicians in Columbia go on call. The management appreciates the 
generous services that have been given freely by members of the 
medical profession. 

"City water, lights, and electric power are used by the or- 
phanage. There is a private sewage-disposal plant that is man- 
aged through septic tanks. The staff consists of Mr. W. M. B. 
Davant, Superintendent, the Rev. Carlisle Courtenay, financial 
agent, Miss M. V. Converse, chief matron; 3 assistant matrons; 
and 3 teachers. The school has 10 grades which parallel the 
grades of the county schools and use the same textbooks. 

"The children are members of different churches in Columbia, 
and they attend service in these churches on Sunday mornings. 
Sunday school is held at the orphanage, and there are daily 
chapel exercises. 

"There are 3 dormitories, one for the larger boys, one for the 
smaller boys, and one for the girls. These dormitories were 
found in excellent condition, though the boys' dormitories are 
old and should be replaced by modern buildings. The girls' dor- 
mitory is a new building, well fitted with baths, toilets, lockers, 
and household equipment. We noted with pleasure the bathing 
facilities that have been installed in the boys' dormitories since 



57 

our last visit. All of the children have individual tooth brushes, 
and most of them have individual combs and hair brushes. A 
number of boys do not need combs and hair brushes as their heads 
have been clipped. 

"We found the kitchen and dining room clean. The dining 
room had its tables furnished with linen, paper napkins, plated 
cutlery, and vases of flowers. This dining room made a very neat 
appearance. 

"Thirteen cows — Holstein and Jersey mixed — furnish milk for 
the institution, giving about twenty-five gallons a day. The man- 
agement is endeavoring to build up a herd with Holstein blood 
predominating in it 

"The laundry has been installed recently and is electrically 
driven. This has an extractor and a washing machine. Ironing 
is done by hand. 

"The produce raised on the farm last year was valued at $8,- 
561.90. It costs $2,072.24 to maintain this farm, which gives a net 
profit of $36,288.93. The cost of maintenance was $25,675.38, the 
remainder of the receipts being paid out on debts, improvements, 
land, interest, insurance, and on like items. 

"We have gone carefully through the financial statement of the 
institution and we are sure that it is economically carried on. It 
costs $183.36 per capita maintenance, which is exceedingly low. 
The Rescue Orphanage is in need of a new dining room and 
kitchen and better dormitory facilities for the boys. The char- 
acter of the institution and the excellent way that it is conducted 
fully justifies the public in giving these buildings with their 
equipments. 

"We commend the directors, of whom Mr. D. W. Robinson is 
Chairman, and the staff at the orphanage for the progress that 
this institution is making. There has been marked improvement 
both in appearance of grounds and buildings and also in the 
efficiency in the management since our last visit." 

Epworth Orphanage. 

We examined 187 children at this orphanage — 80 males and 
107 females out of a total of 212. All were white children who 
were born in South Carolina of native parentage. Their ages 
range from 3 to 19 years inclusive. The following table shows 
their mental diagnoses : 



58 



TABLE XXVII.— MENTAL DIAGNOSIS OF INMATES. 



Diajrnosis 



Number 



Males I Females | Total 



Per Cent 



Males | Females | Total 



Normal 

Dull normal 

Subnormal 

Borderline mental defect 

Mental defect 

Psychopathic personality 
Endocrine disorder 



Total 



54 


84 


37.5 


50.5 


26 


42 


20.0 


24.3 


17 


29 


15.0 


15.9 


3 


12 


11.3 


2.8 


4 


17 


16.3 


3.7 


1 


1 




0.9 


2 


2 




1.9 


' 107 


187 


100.0 


100.0 



44.9 
22.5 
15.5 
6.4 
9.1 
0.5 
1.1 



100.0 



Nine and one -tenths per cent were feebleminded and 6.4 per 
cent were classified as borderline cases of mental defect. One 
hundred and forty-six children showed some physical defect. 
Forty-one children gave a history of behavior difficulties such as 
lying, stealing, cruelty, pugnacity, etc. 

This institution is located on a tract of land comprising 117 
acres near Columbia. The children received are dependents and 
the sources from which they come are the Methodist Membership 
of South Carolina. 

The expenditures for maintenance during the last fiscal year 
were $76,501.73. There was a deficit of $17,000. 

There are separate cottages for boys and girls, two receiving 
cottages for boys, and two for girls, the children remaining there 
until about 14 years old, then being transferred to other cottages. 
The arrangements in the cottages are principally for single 
rooms, two to five beds being in each room. 

The living conditions are very good, and the food ample and 
nutritious. 

The hospital facilities are much better than are found in the 
average orphanage. There is an infirmary of 15 rooms, an oper- 
ating room, and fair equipment. A trained nurse is in charge of 
the building. 

The governing authority consists of a board of trustees ap- 
pointed each year at the annual conference. 

The superintendent is appointed by the board. The other of- 
ficers are appointed by the superintendent. The salary of the 
superintendent is $3,600 a year and maintenance. There is an 
attending physician, who averages three visits a week. There is 
no routine physical examination of the children, and no mental 
examination. There are no case records throwing light upon the 
individual problems presented by each child. 



59 

There are 10 teachers; 7 grammar grades and 4 high-school 
grades are taught. Preparation for college and training in 
business courses are given. There is little vocational training 
given the children. Some physical training and musical training 
is offered. There are boy-scout and girl-scout troops. 

The library consists of 900 volumes with some very good 
selections. 

Many of the children go to college — secure scholarship or loan 
funds. In the case of those who do not go to college, arrange- 
ments are made for securing employment. 

Recommendations. 

1. A new school building, modern in every respect, and with 

modern equipment, is absolutely essential. This year 
a kindergarten is to be opened, but with practically no 
equipment much cannot be expected from it. 

2. The vocational work of the institution should be made edu- 

cational. It should be a part of the school work with 
regular instructors and theory as well as practice should 
be provided. All of the pupils should have a broader 
range of instruction in vocational lines. 

3. There should be a department of physical training, with 

physical inspection and supervised games. The head of 
this department or some one of the faculty should be 
able to prescribe proper diet in special cases. Equip- 
ment for physical training could be made, largely, by the 
boys themselves. A swimming pool should be part of 
the equipment. 

4. A social worker should be employed for general investiga- 

tion, but especially to investigate homes where the 
family fortune has taken a turn for the better, and the 
parent would be able to care for children who are in- 
mates of the institution. Many people shirk the respon- 
sibility once the children have been admitted, and will 
not take them home of their own accord. These children 
occupy places which should be filled by children in real 
need. Many such children are now on the "waiting" list, 
with no immediate prospect of being admitted. 

5. A case record system should be put in so that individual 

problems might be followed up. 



00 

City Orphan Asylum. , 

Fifty-nine children were studied at this orphanage. They 
were all white children. Thirty-four were males and 25 were 
females. All were American born and the parents of all the 
children were American born with the exception of 7 fathers and 
4 mothers. The following table shows the mental diagnosis of 
the children: 

TABLE XXVIII.— MENTAL DIAGNOSIS OF CHILDREN. 

Normal 36 

Dull normal 11 

Subnormal 8 

Borderline mental defect 2 

Mental defect 1 

Unascertained 1 

Total 59 

Forty of the children showed some physical defect while 
only 3 children were considered to have shown marked behavior 
difficulties. 

The institution is located in the city of Charleston. There are 
no grounds worth mentioning other than a garden of about 1 
acre. 

There are no age limits. The kind of children received are 
"children of respectable parentage, no illegitimate children 
taken." The expenditures for maintenance during the last fiscal 
year were $9,000. The sources of income were the city govern- 
ment ($9,000) and the St. Vincent de Paul Society ($700) ; there 
were a few smaller donations from other sources. 

The institution is composed of 2 brick buildings in a good state 
of repair. The governing board is appointed by the mayor with 
the approval of the city council. The executive officer of the 
institution is the principal matron appointed by the city council 
and approved by the Catholic bishop. 

There is no routine physical or mental examination of children. 
A doctor comes when called. The hospital facilities are in- 
adequate. Part of one building is set apart for school rooms. 
There are two rooms, one for boys and one for girls. Kinder- 
garten, 1st, 2nd, 3rd, 4th, 5th, 6th, and 7th grades are taught. 
There is no manual or vocational training. There is no formal 
or directed play. A small library contains about 50 volumes. 

Recommendations. 

1. Proper fire protection. 



61 



2. Adequate lighting system. 

3 Additional acreage for purposes of cultivation and for play- 
grounds. 
4. Up-to-date lavatories. 

Almshouses. 

The following almshouses were studied: Anderson County 
Almshouse, Lexington County Almshouse, Pickens County Alms- 
house, Charleston Home and Ashley Asylum for Aged, Charles- 
ton. 

One hundred and sixteen inmates were given individual exam- 
inations in these almshouses. Eighty were white and 36 were 
colored. Forty-eight were males and 68 were females. . The fol- 
lowing table shows the marital conditions of the inmates: 





TABLE XXIX.— MARITAL CONDITION 


OF INMATES. 








Marital Condition 


| Males 


Females 


Total 




20 
8 

17 
2 
1 


23 
5 

39 
1 


43 




13 




56 




3 




1 










Total 


48 


68 


116 







Thirty-seven per cent, better than 1 out of every 3 persons, had 
never been married. 

TABLE XXX.— MENTAL DIAGNOSIS OF INMATES. 



Diasnosis 


1 


Number 






Per Cent 




| Males 


1 
Females Total 


Males 


Females 


Total 


Normal 


1 
3 

4 

"i2 

26 

1 


2 

"*4 
2 

28 
2 
2 

27 
1 


3 
3 

8 
2 

40 
2 
4 

53 

1 

1 


2.1 
6.2 
8.3 

25.6 

"i.2 
54.2 
.... 

100.0 


2.9 

' 5.9 
2.9 

41.2 
2.9 
2.9 

39.7 
1.5 


2 6 


Dull normal 


2 6 


Subnormal 


6 9 


Borderline mental defect 


1 7 


Mental defect 


34 5 


Psychopathic personality 


1 7 


Epilepsy 


3 4 


Mental disease 


45 7 




9 






Total 


48 


68 


116 


100.0 


100 







The most striking thing in this table is the frequency of mental 
disease. Forty-five and seven-tenths per cent of the inmates were 
classified as suffering from some form of mental disease.' Insane 
persons should not be kept in county almshouses. Thirty- four 



62 

and one-half per cent of the inmates were feebleminded — that 
is, at least 1 out of every 3 persons in the almshouses studied was 
a feebleminded individual. 

Seventy-six per cent of these individuals were in such poor 
physical condition as to be in need of medical treatment. 

The thing that stood out in our survey of the almshouses was 
the fact that we were dealing with mentally sick and physically 
disabled persons — with individuals who, in a large proportion of 
cases, were medical problems. This is but in keeping with our 
findings in other almshouses throughout the country. 

It does seem to us that the strong public sentiment of the 
future will seek a more humane solution of the problem these 
dependents present than merely caring for them in poorhouses. 
We believe that the public conscience will ultimately demand, 
with the disappearance of county almshouses, county or state 
hospitals equipped with the most modern medical facilities for 
the care and treatment of all dependents who are urgently in 
need of such; organized and equipped hospitals, directed and 
manned by competent medical staffs. 

Insane and feebleminded persons should not be detained in 
almshouses. 

SUMMARY. 

The data obtained from this survey may be briefly summarized 
as follows: 

Two and eight-tenths per cent of the white public school chil- 
dren and 4.2 per cent of the colored pupils were feebleminded. 
Applying these figures to the entire school population in the first 
six grades of the state, we have approximately 13,000 defective 
individuals. 

Feeblemindedness was found to be almost twice as frequent in 
rural as in urban communities. 

Six special types of problem cases deserve consideration: the 
retarded child, the mentally defective, the nervous and psycho- 
pathic child, the epileptic child, the child with speech defect, and 
the child showing disorders of conduct. 

Eight and six-tenths per cent of the white inmates and 9.8 per 
cent of the negroes in the State Penitentiary were insane. Ap- 
proximately 13.5 per cent of the inmates of the State Peniten- 
tiary were feebleminded; 5.2 per cent of the whites and 18.2 per 



63 

cent of the negroes were feebleminded. It is interesting to add 
that 40 per cent of the inmates of this institution were repeated 
offenders. 

In a study of 234 jail inmates in several county jails in the 
state. 10.5 per cent of the white and 15.2 per cent of the negro 
population were found to be feebleminded. Four white persons 
and 3 negroes suffering from insanity were found in the county 
jails. 

Fourteen and three-fourths per cent of the "run of the mine" 
of the Juvenile Court in the city of Columbia were found to be 
feebleminded; 50 per cent of the children passing through the 
Juvenile Court were handicapped by some abnormal nervous or 
mental condition. 

Twenty and one-tenth per cent of the inmates in the various 
juvenile delinquent institutions studied were found to be feeble- 
minded — 20.6 per cent of the colored and 19.7 per cent of the 
white. 59.2 per cent of the inmates of these institutions could be 
classified as deviating in some way from normal mental health. 

The juvenile dependent institutions of the state showed that 
7.4 per cent of the inmates were feebleminded and approximately 
33.1 per cent classifiable as of subnormal intelligence, mentally 
defective, or suffering from psychopathic conditions. 

Forty-five and seven-tenths per cent of the inmates of the alms- 
houses studied in this survey were suffering from mental disease, 
while 34.5 per cent were found to be feebleminded. 

CARE OF THE INSANE. 

In 1751 the South Carolina Assembly passed an act providing 
for the care of slaves who may become lunatic (especially the 
slaves of persons who are too poor to care for them). 

In the early years insane persons and paupers were handled 
together. 

In 1818 an act was passed providing for the care of white 
insane persons, but the first building was not completed until 
1828. The first annual report shows that not a single person had 
been admitted to this institution, although they advertised for 
patients in adjoining estates. 

The act creating the institution authorized spending $30,000.00 
for a site and "building an asylum for lunatics and deaf and 
dumb persons." It was soon recognized that the latter could not 



64 

be handled along with the insane, so that 4 acres of land were 
purchased near the city of Columbia and a building was started 
in 1822. This is one of the oldest buildings still in use in this 
country for the insane. For many years the Columbia asylum 
took care of patients from other states. 

In 1848 an act was passed providing for the admission of 
insane negroes. 

Since 1915 at least $150,000.00, have been appropriated each 
year for permanent buildings. The institution has only had 5 
superintendents in its history. 

The South Carolina State Hospital is located within the city 
limits of Columbia. It owns 2,730 acres of land; 735 acres are 
under cultivation. There are 8 buildings, one large main build- 
ing centrally located, the others being arranged to conform 
architecturally with a view to landscape gardening. The orig- 
inal building as noted above was completed in 1828 and is now 
used for private colored patients. In 1883 the main building was 
erected. It is of the Kirkbride type ; in 1897 the Parker building 
was erected; in 1907 the Taylor building; in 1904 the Tilley 
building ; in 1909 the North building and the Parker annex ; and 
in 1918 the building for tubercular patients. The construction 
of all the buildings with the exception of this latter one is of brick. 
The buildings are all in a good state of repair except those for col- 
ored patients. They are lighted by electricity from the Central 
Lighting System of Columbia. The heating is by a central heating 
plant for all the buildings except the building in which the 
colored female patients are housed. This building has its own 
furnace. Proper fire protection has been provided for. The 
water supply and sewage disposal are connected with the city 
systems. 

In the Kirkbride building the wards average about 100 cubic 
feet of air space to each person; there are 13 dormitories for 
white males, 18 for white females, 7 for colored females, and 7 for 
colored males. All told there are 45 dormitories. There is an 
average of one private room for each 10 ward beds. In the Kirk- 
bride building there is one private room for each 6 ward beds. 

All the buildings have splendid modern bath rooms and toilets, 
except that in the colored buildings the bath rooms seem rather 
dark and old. The institution is thoroughly screened for fly 
protection. 



05 

For the old and feeble, the disturbed ward, the tubercular and 
the colored wards there are private dining rooms. For the rest of 
the patients are 2 congregate dining rooms, one for male and 
one for female patients. There is a modern congregate kitchen 
where all the cooking is done for the patients and employees with 
the exception of the medical staff. The food is well selected, is. 
of good quality and ample in quantity. 

The hospital has its own refrigeration plant, a modern laun- 
dry, amusement hall, chapel, etc. 

The administrative control of the hospital is under a Board of 
Regents, composed of 5 men and a secretary and treasurer. The 
latter receives $3,000.00 a year and house and fuel. The Superin- 
tendent is appointed by the Board of Regents; his salary is 
$6,000.00 a year with maintenance. Other members of the staff 
of the hospital are appointed by the Superintendent. 

The resident medical staff consists of the Superintendent, Dr.. 
C. F. Williams; the Medical Director, Dr. J. F. Munnerlyn; 7 
assistant physicians and one dentist. One of the assistant phy- 
sicians is a woman. There is a consulting medical staff, composed 
of 4 surgeons, one dermatologist, one pathologist in charge of the 
pathological laboratory and one eye and ear specialist. All assis- 
tant physicians are quartered in the main building. The Medical 
Director has a separate cottage. 

There are approximately 3,000 patients and the rated capacity 
is 2,450. The ratio of physicans to patients is 1 to 25 for the 
reception service ; one to 60 for the acute service and 1 to 270 for 
the entire hospital. There are 2 big services, entirely separate 
from each other, the male and the female. There are 3 physicians 
on each service ; these services are again subdivided. All of the 
medical work of the hospital is under the close direction of the 
Medical Director. Staff meetings are held 4 times a week, which 
are attended by all the physicians in the hospital. 

The case histories are well worked up and on the accepted 
standardized forms. 

About 40 or 50 autopsies are done during the year. 

There is a well equipped operating room and the surgery is 
done by visiting surgeons. 

There is a very good library and all the latest periodicals are 
taken. 



Reception Service. 

The Reception Service has 4 receiving wards, 2 for white (one 
for male and one for female) and 2 for colored (male and 
female). There are 16 nurses in the Reception Service in charge 
of a well trained graduate nurse — about 20 patients at a time on 
each receiving ward. The average length of stay of each patient 
in this service is from 10 to 14 days. On admission each 
patient is given routine, preliminary treatment, is kept in bed for 
4 days and when necessary, packs, continuous baths, etc. are 
authorized. 

Restraint and seclusion are scarcely ever used. There is no 
hydrotherapeutic department. One ward is called the "Pack" 
room. 

There are no facilities for electrotherapy. 

Occupational therapy is under the direction of Miss Florence 
Elliott, a graduate nurse, with special training along these lines. 
She has 7 female and 2 male assistants. 55 per cent of the 
patients of the hospital are considered to be employed along some 
occupational lines ; making toys, weaving, basketry, needlework, 
bookbinding, printing, shoe repairing, mattress and broom mak- 
ing, blacksmithing, gardening and farming. One resident dentist 
does all of the dental work of the hospital. 

The general plan of distribution of patients is as follows : 

(a) Acute service. 

(b) Custodial service. 

(c) Chronic disturbed ward. 

(d) Infirmary ward. 

Acute Wards have regular hospital service — a press button 
beside each bed, daily sick charts, diet kitchen, etc. There are 
separate wards for the segregation of contagious diseases. A 
modern well-equipped building has been provided for the 
care of cases of tuberculosis. The aged and infirm are provided 
with separate wards and special dining rooms. Suicide cases are 
kept in Infirmary Wards under constant supervision. One spe- 
cial building is given over to chronic disturbed patients. There 
is a pack room in this building also. There are between 25 and 
30 epileptics who are mostly housed along with the group of 
"Idiots and Imbeciles." 



67 



Parole. 

Approximately 20 per cent of the population are given parole 
on the grounds. Signed parole cards agreeing not to go beyond 
certain boundaries are required. 

Parole is granted when deemed advisable to any convalescent 
patient at the request of friends or relatives for a period of 6 
months, after which the patient is automatically discharged. 

At the time of our inspection the hospital had no social worker 
to look after paroled cases. It was planned, however, to employ 
one, beginning January 1922. 

The diversions consist of dances, moving pictures, an orchestra 
and athletic games. 

The classification of mental diseases adopted by the American 
Medico-Psychological Association and advocated by the National 
Committee for Mental Hygiene have been adopted. A definite 
distinction is made between first admissions and readmissions. 
The statistical record cards of the National Committee for 
Mental Hygiene are being used for admissions, readmissions, dis- 
charges, deaths and transfers. 

Out-patient Department. 

On 2 days a week, Tuesday afternoon from 3 to 4, and 
Thursday morning from 11 to 12, an Out-patient Clinic is held. 
There was at the time of our inspection no social service depart- 
ment. 

State Park. 

A part of the hospital is located at the State Park, six miles out 
in the country. There is here one large brick fireproof building, 
4 stories, with basement which houses 353 female colored patients 
and is very much overcrowded. The dormitories contain over 100 
beds each. The colored tubercular patients are kept in a small 
separate ward. There is one white matron in charge who has one 
white assistant. All of the other attendants are colored. There is a 
bath and toilet on each floor, with showers in the basement. The 
building for the colored men, about one-half mile distant, is a 
one-story concrete structure, capacity 105 — which now has 98 men 
in it. These men are mostly those who can do farm work. 

The physician in charge has a cottage nearby. 

The plan is eventually to build up this farm so that all the 
colored patients will be cared for here. 



68 



Conclusions. 

This is a well run institution, and we have nothing but the 
highest praise for the Superintendent and the governing authori- 
ties. There are certain needs to which we would like to call 
attention. 

Recommendations. 

1. Receiving psychopathic pavilion for the reception and 

treatment along the most modern and approved lines of 
all acute and recoverable cases. 

2. A new building sufficient to accommodate 700 colored 

patients; 500 men and 200 women, to be located at the 
State Park. 

3. An employees 5 building. 

4. Convert present building occupied by negroes into wards 

for white men. This will soon be needed owing to the 
increase in population. 

5. Convert one of the negro buildings into an occupational 

building and work shop for white men patients. 

6. Means should be provided for open wards on the female 

side. 

7. Mental Clinics for the Community. This we believe is 

one of the most important phases of the hospital's work. 
A large proportion of sufferers from mental disease 
may, by early recognition and proper treatment, be pre- 
vented from having to be sent to the hospital. There 
is no question but what the amount of service these 
clinics can offer in the Courts and in diagnosing the 
mentally handicapped children in the public schools, 
can never be estimated in dollars and cents. These 
clinics through their social service department would 
enable the hospital to handle a great many recoverable 
cases out in the community, at far less cost to the state. 

CARE OF THE FEEBLEMINDED. 

The State Institution for the Feebleminded was established in 
1918 and opened in 1920. It is located at Clinton, South Caro- 
lina, on a tract of land containing 1,188 acres. Three hundred 
acres are under cultivation. The institution is on the Seaboard 
Air Line. 



69 

There are two brick dormitories, one for females and one for 
males, and four temporary frame buildings. The brick cottages 
were erected in 1920 and are practically fireproof. There are 
two wards in each dormitory building. There is only one single 
room in each building and that is for the sick. There is one 
bathroom and one toilet in each building. Each bathroom has 
four showers and one tub ; each toilet has four stools, four basins, 
and one sink. There is one congregate kitchen for the entire in- 
stitution ; two dining rooms, one for boys and one for girls, 
with a small partitioned dining room for employees. 

The ventilation by windows and transoms provides for about 
one foot of window space to every three feet of floor space. 
Every window is completely screened. The lighting is electric 
from the city of Clinton. Heating is steam for the two dormi- 
tories; wood and coal stoves for the frame buildings. The water 
supply is from wells on the grounds. The water is pumped up 
to a 15,000 gallon capacity wooden reservoir. The sewage dis- 
posal is by a three chamber septic tank for each dormitory. 
Other buildings are connected with this line. 

There is no central power house. The heating system is in each 
building, but could be connected up to a central heating system 
at very little expense. 

There is a laundry in a temporary frame building; one electric 
washing machine ; one extractor and a drying tumbler ; one five 
horsepower steam boiler and four small electric hand irons. 

There are no shops. A small room in the temporary administra- 
tion building is used for a chapel, manual school work, and an 
amusement hall. 

There is no morgue. 

The governing authority of the institution is the State Board 
of Public Welfare, which appoints an advisory committee. The 
superintendent is selected by the State Board of Public Welfare. 
His salary is $3,000 a year with house, water, light, and fuel. 

There is no resident medical staff, Dr. B. O. Whitten, the 
Superintendent, being the only physician connected with the 
institution. There is a psychologist who assists the superinten- 
dent in making the examinations of each child and also helps in 
the teaching. There is one supervisor, 2 teachers (whose salaries 
are $40 to $45 a month), 3 male attendants, 1 night watchman, 2 
female attendants for day duty and one for night, 1 woman in 



70 

charge of the kitchen, 1 woman in charge of the laundry, and 1 
colored laborer. 

There are 103 children, all white, at the institution, of whom 

50 are boys and 53 are girls. Provision is made for the segrega- 
tion of the children by sex. 

The teachers give academic and occupational training in the 
first four grades, but not vocational and industrial training. A few 
rugs are made by hand. 

The provision for the sick includes 2 small rooms, one in each 
building. For the care of the tuberculosis cases one room has 
been screened off from part of the porch of the frame building 
used for the school. There is one case of tuberculosis being treated 
at the present time. 

There is no parole work as yet developed by the institution, the 
institution being too young for this phase of the work. 

There is no out-patient department. 

The mentality of the population is seen in the following table : 

TABLE XXXI.-MENTAL DIAGNOSIS OF INMATES. 

Insane 2% 

Psychopathic personality < 5% 

Morons 85% 

Imbeciles 15% 

Note: The insane and psychopathic individuals are also men- 
tally defective. The actual ages of the inmates ranged from 7 to 

51 years. The median age is 21 years. 
All of the inmates were American born. 

The above statement does not indicate that the state of South 
Carolina has yet begun to appreciate that feeblemindedness is 
one of the largest and most serious social problems with which it 
has to deal. 

Better care of the feebleminded is not a sentimental matter and 
does not end with providing a little home for a few dependent 
feebleminded children, but is now regarded universally as a 
hard headed business proposition. 

This institution has provision for one hundred and three pa- 
tients while there are several thousand in the community who 
need segregation and training. It must not be thought that the 
state is in any way evading the expense of this problem. It can 
be demonstrated that the great majority of feebleminded persons, 
if not trained and supervised, are either dependent or delinquent 
and that their support comes out of the public purse some way 



71 

or other if not through a legislative budget. (They are supported 
either by begging, or by relatives, or by churches, social organiza- 
tions, charitably minded individuals, or are cared for in alms- 
houses, orphanages, jails, industrial training schools, state prison; 
in some way or other the public is paying the bill.) The pity of 
it all is that it is being done in the costliest and most inhumane 
way possible, for the majority of all mental defectives can be 
trained to become self-supporting and prevented from becoming 
criminal. 

The following is presented as a minimum program for The 
State Training School for the Febleminded : 

Recommendations. 

1. Two new dormitory buildings. 

2. One employees' cottage. 

3. A .school building which will include facilities for aca- 

demic, industrial and vocational training, as well as a 
gymnasium and chapel. 

4. Permanent service building including a kitchen and dining 

room. 

5. A full time physician. 

The above recommendations, we believe, are urgent needs. 

The keynote of any and every program f cr dealing with men- 
tally defective individuals is the state institution. Around it 
must revolve all other state machinery intended for the solution 
of this problem. 

Mental defect is a problem the size and importance of which 
is scarcely realized by the majority of states. In only a few 
states has it been considered with any degree of intelligence or 
foresight by legislators. The army figures showed that this 
condition was approximately ten times more frequent than drug 
addictions or disabling alcoholism, and three times more fre- 
quent than insanity. It is not apparent from this survey that the 
state of South Carolina is giving this condition the considera- 
tion, financial and otherwise, that its relative size and serious- 
ness would demand. 

The present institution is a little home caring for a few 
feebleminded children. It is not equipped to do much more 
than give the ordinary physical comforts and humane care 
to the children. And yet the experience of other states has 
shown that mental defectives may be intensively trained along 



72 

industrial lines, and in a large measure made self-supporting. 
We would urge the wisdom of South Carolina's profiting by 
the success achieved along these lines in other states. We would 
appeal for sympathetic interest, encouraging support, and finan- 
cial backing for this institution. As a program we offer the fol- 
lowing : 

Plan an institution that will remove a large number of feeble- 
minded from the community; that will satisfy parents that 
their children will be humanely treated; insure the happiness 
and comfort of the children; educate or train each one accord- 
ing to his abilities; provide such facilities as will utilize the 
labor of the trained inmates to reduce the cost of their support ; 
secure and retain highgrade employees; build to satisfy all re- 
quirements; meet the topographical conditions of the site; sepa- 
rate the inmates in groups for proper classification; plan the 
buildings for simplicity and economy of administration with a 
minimum outlay for repairs and upkeep; organize and develop 
scientific research into the causes underlying mental defect, its 
extent, and its menace, and the best methods for meeting and 
solving the problem that it presents; parole and supervise out 
in the community those children who have profited well by 
institutional training and are able to adapt themselves to normal 
life; furnish clinical facilities for diagnosing mental defect 
in the general community, in the public schools, and in the 
courts; offer opportunity for the training of teachers and medi- 
cal men in the diagnosis, treatment and training of mental de- 
fectives; and finally, do all this at a cost in accordance with 
modern business standards. 

CONCLUSIONS. 

This survey has now been under way for one year. It has 
included a study of several thousand school children and has 
secured some very significant data on the frequency of mental 
handicaps among pupils in the public schools. It has extended 
the study to two of the most serious social problems in the state — 
crime and dependency. 

Of the many conditions we found needing consideration, feeble- 
mindedness, we believe, stands out by itself as by all odds the 
most pressing problem deserving of attention. 



RECOMMENDATIONS. 

1. A development program for the Institution for the Feeble- 
minded. We recommend the appropriation of $500,000 as a 
five year program — $100,000 per year for five years. 

2. The development of mental clinics, the State Hospital 
and the Institution for the Feebleminded to serve the schools, 
the courts, and the general community. In this way early 
cases of mental disease can be diagnosed, treated, and in many 
instances hospitalization prevented. Cases of mental disease 
and mental defect could be detected in the courts, the criminal 
conduct of the insane and feebleminded persons cut short, and 
their dangerous and expensive careers prevented; while in the 
public schools, feebleminded and mentally handicapped children 
could be early recognized and given proper training and super- 
vision and. in the case of those who need it, segregation. These 
clinics can be developed at an exceedingly small cost and yet the 
service they will render will be tremendous and cannot be meas- 
ured in dollars and cents. 

3. State-wide special classes for the training of mentally 
defective children. For the most part the burden of fitting 
the majority of feebleminded individuals to earn a living in life 
will continue to rest upon the public school authorities. 

4. Actual state supervision of all feebleminded children who 
are delinquent and dependent. If carefully selected, properly 
trained, and intelligently supervised, many feebleminded per- 
sons may be handled with safety out in the community, and thus 
the state saves the expense of their maintenance. 

5. Clinical facilities for mental examination of inmates of 
penal, correctional and juvenile delinquent institutions. 

6. Separate institutional care of the criminal insane and 
adult defective delinquents. 

7. The extension of juvenile courts throughout the state. 



LIBRARY OF CONGRESS 



021 060 435 2 



